6.9 m people suffer from COPD symptoms in Pakistan: study

The first regional research on chronic obstructive pulmonary disease (COPD) in the Middle East and Africa (MEA) region suggests that more than 13 million people in MEA suffer from COPD secondary to cigarette smoking with the prevalence rate in Pakistan as high as 2.1 percent in the population aged 40 years and above.
The prevalence estimate also appears to be the tip of the iceberg as given that other risk factors such as waterpipe smoking or exposure to burning biomass fuel were not considered in the calculation.
The BREATHE study (an observational cross-sectional epidemiology study in chronic obstructive pulmonary disease), sponsored by GSK, was conducted in 11 countries (Pakistan, Algeria, Lebanon, Egypt, Jordan, Morocco, Saudi Arabia, Syria, Tunisia, Turkey, UAE) in the MEA region with over 60,000 subjects aged 40 years or older in order to estimate the prevalence of symptoms of COPD within the general population.
The COPD is a general name given to a number of conditions including chronic bronchitis and emphysema. The COPD causes the airways in the lungs to become narrower, making it more difficult for the air to move into and out of the lungs.
According to Dr Javaid A Khan, member BREATHE Study Steering Committee and Chairman Medicine Department at Aga Khan University (AKU) Hospital, ‘The BREATHE study has for the first time quantified the true burden of COPD, both in terms of its societal cost and the impact the disease has on patients and their families in the region. This landmark study is a call to action for all of us to improve the prevention, diagnosis, management and quality of life of the patients living with this chronic condition.
The BREATHE study revealed that many patients are poorly informed about COPD and its management and much can be done to improve disease education. Better patient education and more effective patient-physician communication are clearly required and the opening up of alternative information channels may complement the patient-physician dialogue.
The overall prevalence of COPD in the 11 countries is 3.6 percent which is almost similar to the proportion of the population who have asthma or chronic heart failure and 10 times higher than the proportion with epilepsy in the same age group.
Mortality and disability from the COPD are expected to rise in developing countries, primarily due to the increased rate of smoking, a known risk factor for the disease. The BREATHE study findings revealed that smoking remains a major and growing public health issue in Pakistan with estimated cigarette smoking rate as high as 15.1 percent while cigarette and waterpipe (or both) among men is as high as 30.1 percent and 2 percent in women.
Dr Nadeem Rizvi, Head of Department, Chest Medicine at Jinnah Postgraduate Medical Centre, stated: ‘The BREATHE study represents a cornerstone for building a long-lasting commitment to improving respiratory care in Pakistan. The study was published in respiratory medicine. We hope that the increased awareness of the BREATHE study findings will improve public health planning through governments and health service managers and ultimately improve the lives of patients living with this chronic debilitating disease.’
A number of important findings emerged from the BREATHE study that will have a significant impact on the management of COPD over the coming years. The study revealed that only 10 percent of the subjects in Pakistan had their lung function tested in the last year and nearly 27 percent of the COPD population reported having co morbidities. Furthermore, the health economic burden of managing the disease is huge in Pakistan. Around 33 percent of the subjects have been hospitalised due to their COPD symptoms and similarly 27 percent of the COPD patients visited an emergency room because of their respiratory condition.
Until now, little information has been available concerning the prevalence of COPD in MEA, and the true extent of the disease burden in this region has been largely unrecognised.