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COMMENTARY
Year : 2006  |  Volume : 23  |  Issue : 2  |  Page : 93-94 Table of Contents   

Respiratory disease epidemiology in India


Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh., India

Correspondence Address:
S K Jindal
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-2113.44419

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How to cite this article:
Jindal S K. Respiratory disease epidemiology in India. Lung India 2006;23:93-4

How to cite this URL:
Jindal S K. Respiratory disease epidemiology in India. Lung India [serial online] 2006 [cited 2020 Oct 25];23:93-4. Available from: https://www.lungindia.com/text.asp?2006/23/2/93/44419

India is a vast country with an enormously variable population. There are large differences in geographical, environmental, ethnic, religious, cultural and socioeconomic parameters in different population groups in India which affect the human health and disease occurrence. Therefore, the study of disease epidemiology in India is singularly difficult. Nonetheless, it is of paramount importance to know of their prevalences and risk factors. Factually speaking, the great variability makes it even more crucial to do an epidemiological mapping of diseases in the country.

Information on epidemiology of chronic respiratory problems in India is available through several small and sporadic studies conducted by individual investigators from time to time. The two most common respiratory disorders which have been studied included asthma and chronic obstructive pulmonary disease (COPD). But the studies have often lacked in uniformity of definitions, designs, methodologies and reporting techniques. Moreover, the samples sizes were generally small but for an occasional report.

In the last decade, we have had studies on prevalence of asthma in adults from Mumbai and Chandigarh [1],[2] . There are also a few reports on asthma in children including the results of the International Study of Asthma and Allergies in Childhood (ISAAC) [3],[4],[5],[6] . Information on COPD is rather limited but for a few surveys [7],[8] . It had been therefore difficult to assess the magnitude of the problem based on reasonable assumptions and estimates.

Fortunately, the Indian Council of Medical Research constituted a National Asthma Task Force with whose sponsorship a multicentric study on respiratory disease epidemiology was undertaken at four centres in India i.e. Chandigarh (the coordinating Centre), Delhi, Bangalore and Kanpur. This study lays the foundation not only for assessment and estimation of the disease burden and management strategies but also for future research in chronic airway obstruction.

The mean asthma prevalence in this study is reported in 2.38% of 73605 individuals of over 15 years of age [9] . One or more respiratory symptoms were present in 4.3-10.5% subjects. Female sex, advancing age, usual residence in urban areas, lower socioeconomic status, history suggestive of atopy, history of asthma in a first degree relative and all forms of tobacco smoking were associated with significantly higher odds of having asthma [9] . There were a few centre to centre differences underlining the importance of assessment in different regions. In a report published in this issue of the journal, utilizing the same study design and methodology, the overall prevalence of asthma in Jaipur, Rajasthan has been reported as 0.96% with almost similar risk factors [10] Analysis of the 62109 nonsmoking subjects in the ICMR study revealed that the environmental tobacco (ETS) exposure was an important risk factor for asthma and respiratory symptoms [11] . The mean prevalence of COPD defined by the criteria of chronic bronchitis, was 4.1% in 35295 adults of over 35 years of age in whom tobacco smoking and ETS exposure among nonsmoker individuals were found as important risk factors [12] . In a separate analysis for the population prevalence of tobacco smoking, 15.6% were detected as ever-smokers [13] . Bidi was reported as the commonest form of smoking, especially in the rural areas.

The results of this study have helped to answer some of the questions and fill some of the lacunae in the knowledge of epidemiology of asthma, tobacco smoking and COPD. An important observation made for the first time in the study is the clear demonstration of a statistically significant association between ETS exposure and COPD in nonsmoking patients [12] .

A lot more needs to be studied on these two common disorders responsible for a huge health care burden. This is the time to assess the problem of chronic airways obstruction beyond its routine recognition by cough, wheezing and breathlessness responding variably to bronchodilators and/ or other inhaled drugs.

 
   References Top

1.Chowgule R, Shetye VM, Parmar JR, Bhosale AM, Khandagale MR, Phalnitkar SV et al. Prevalence of respiratorysymptoms, bronchial hyperreactivityand asthma in a mega city : Results of the European Community Respiratory Health Survey in Mumbai. Am I Respir Crit Care Med 1998; 158: 547-554.  Back to cited text no. 1    
2.Jindal SK, Gupta D, Aggarwal AN, Jindal RC, Singh V. Study ofprevalence of asthma in adults in North usinga standardized questionnaire. JAsthma 2000,37:345-351.  Back to cited text no. 2    
3.Gupta D, Aggarwal AN, Kumar R, Jindal SK. Prevalence of bronchial asthma and association with environmental tobacco smoke exposure in adolescent school children in Chandigarh, North India. I Asthma 2001; 38 : 501-07.  Back to cited text no. 3    
4.Chhabra SK, Gupta CK, Chhabra P, Rajpal S. Risk factors for development of bronchial asthma in children in Delhi. Ann Allergy Asthma Immunol 1999; 83: 385-90.  Back to cited text no. 4  [PUBMED]  
5.Paramesh H. Epidemiologyofasthma in India. Ind JPediat 2002; 69 : 309-12.  Back to cited text no. 5    
6.The International Study of Asthma and Allergies in Children (ISAAC) Steering Committee : Worldwide variations in the prevalence of symptoms of asthma and allergies in childhood. Fur Respir 11998, 12 : 315-355.  Back to cited text no. 6    
7.Jindal SK Aggarwal AN, Gupta D. A review of population studies from India to estimate National burden of Chronic Obstructive Pulmonary Disease and its association with smoking. Ind I Chest Dis Allied Sci 2001; 43: 139-147.  Back to cited text no. 7    
8.Chhabra SK, Chhabra P, Rajpal S, Gupta RK. Ambient air pollution and chronic respiratory morbidity in Delhi. Arch Environ Health 2001; 56: 58-64.  Back to cited text no. 8  [PUBMED]  
9.Aggarwal AN, Chaudhry K, Chhabra SK, D Souza GA, Gupta D, Jindal SK, Katiyar SK, Kumar R, Shah B, Vijayan VK. Prevalence and risk factors for bronchial asthma in Indian adults : multicentre study. Indian I Chest Dis Allied Sci 2006; 48 : 13-22.  Back to cited text no. 9    
10.Gupta PR, Mangal DK. Prevalence and risk factors for bronchial asthma in adults in Jaipur District of Rajasthan (India). Lung India 2006; 23: 51-56.  Back to cited text no. 10    
11.Gupta D, Aggarwal AN, Chaudhry K, Chhabra SK, D'Souza GA, Jindal SK, Katiyar SK, Kumar R, Shah B, Vijayan VK. Household environmental tobacco smoke exposure, respiratory symptoms and asthma in non-smoker adults : A Multientric Population Study from India. Ind J Chest Dis Allied Sci 2006; 48 : 31-36.  Back to cited text no. 11    
12.Jindal SK, Aggarwal AN, Chaudhry SK, D'Souza GA, Katiyar SK Kumar R, Shah B, Vijayan VK. A in ulticentric study on epidemiology of chronic obstructive pulmonary disease and its relationship with tobacco smoking and environmental tobacco smoke exposure. Indian I Chest Dis Allied Sci 2006; 48 : 23-29.  Back to cited text no. 12    
13.Jindal SK, Aggarwal AN, Chaudhry K, Chhabra SK, D'Souza GA, Katiyar SK, Kumar R, Shah B, Vijayan VK. Tobacco smoking in India; Prevalence, quit rates and respiratory morbidity. Ind I Chest Dis Allied Sci 2006; 48:37-42.  Back to cited text no. 13    




 

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