Chest

Chest

Volume 133, Issue 2, February 2008, Pages 343-349
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Original Research
COPD
Prevalence of COPD in Five Colombian Cities Situated at Low, Medium, and High Altitude (PREPOCOL Study)

https://doi.org/10.1378/chest.07-1361Get rights and content

Background

The prevalence of COPD in Colombia is unknown. This study aimed to investigate COPD prevalence in five Colombian cities and measure the association between COPD and altitude.

Methods

A cross-sectional design and a random, multistage, cluster-sampling strategy were used to provide representative samples of adults aged ≥ 40 years. Each participant was interviewed (validated Spanish version of the Ferris Respiratory Questionnaire) and performed spirometry before and after 200 μg of inhaled salbutamol, using a portable spirometer according to American Thoracic Society recommendations. COPD definitions were as follows: (1) spirometric: fixed ratio (primary definition): FEV1/FVC < 70% after bronchodilator; (2) medical: a diagnosis of chronic bronchitis, emphysema, or COPD made by a physician; (3) clinical: cough and phlegm ≥ 3 months every year during ≥ 2 consecutive years (chronic bronchitis). Analysis was performed using statistical software.

Results

A total of 5,539 subjects were included. The overall COPD prevalence using the primary definition (spirometric) was 8.9%, ranging from 6.2% in Barranquilla to 13.5% in Medellín. The prevalence measured by the spirometric definition was higher than medical (2.8%) and clinical (3.2%) definitions. After the logistic regression analysis, the factors related with COPD were age ≥ 60 years, male gender, history of tuberculosis, smoking, wood smoke exposure ≥ 10 years, and very low education level. There was a nonsignificant tendency toward larger prevalence with higher altitude.

Conclusion

COPD is an important health burden in Colombia. Additional studies are needed to establish the real influence of altitude on COPD prevalence.

Section snippets

Design and Sampling Technique

PREPOCOL was a cross-sectional, population-based, observational, and analytical study done in urban areas of five Colombian cities (Barranquilla, Bogotá, Bucaramanga, Cali, and Medellín) located at different altitudes (18 to 2,640 m). Using an expected COPD prevalence from 9.1 to 12.7% obtained from two Latin-American studies,1415 a 1.0 adjustment for design effects, and an accepted 5% for type I error, it was estimated a sample of 1,100 subjects in each city. Subjects were selected by a

Results

From a total of 7,149 households visited in the five cities, 5,539 subjects were included (3,701, women; 66.8%). Table 1 shows the demographic characteristics. The highest rates of contact household failures and refusals (15.4% and 20.7%, respectively) were found in Bogotá.

Discussion

As far as we know, PREPOCOL is the first probabilistic population study done in Colombia and the second in Latin America15 that use a spirometric definition (postbronchodilator FEV1/FVC < 70%) as the primary criterion for establishing the COPD prevalence. Although this fixed ratio may underestimate the prevalence of obstruction in young people and overestimate it in older individuals, we selected it to facilitate the comparison of the prevalence with that determined by other studies.1220 The

References (50)

  • MerenM et al.

    Asthma, chronic bronchitis and respiratory symptoms among adults in Estonia according to a postal questionnaire

    Respir Med

    (2001)
  • LindbergA et al.

    Prevalence and under-diagnosis of COPD by disease severity and the attributable fraction of smoking: report from the Obstructive Lung Disease in Northern Sweden Studies

    Respir Med

    (2006)
  • DennisR et al.

    Wood smoke exposure and risk for obstructive airways disease among women

    Chest

    (1996)
  • WillcoxPA et al.

    Chronic obstructive airways disease following treated pulmonary tuberculosis

    Respir Med

    (1989)
  • HorneSL et al.

    Ethnic differences in the prevalence of pulmonary airway obstruction among grain workers

    Chest

    (1989)
  • GOLD

    Global Initiative for Chronic Obstructive Lung Disease. Global strategy for diagnosis, management, and prevention of chronic obstructive lung disease, update 2005

    Am J Respir Crit Care Med

    (2001)
  • CelliBR et al.

    Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper

    Eur Respir J

    (2004)
  • World Health Organization
  • CelliBR et al.

    Population impact of different definitions of airway obstruction

    Eur Respir J

    (2003)
  • ManninoDM

    Epidemiology and global impact of chronic obstructive pulmonary disease

    Semin Respir Crit Care Med

    (2005)
  • AntoJM et al.

    Epidemiology of chronic obstructive pulmonary disease

    Eur Respir J

    (2001)
  • Ministerio de Salud. República de Colombia. II Estudio nacional de factores de riesgo para enfermedades crónicas, 1998...
  • HnizdoE et al.

    Chronic pulmonary function impairment caused by initial and recurrent pulmonary tuberculosis following treatment

    Thorax

    (2000)
  • MaldonadoD et al.

    Humo de la caña de azúcar y compromiso del sistema respiratorio (Sugar cane smoke and respiratory system affectation.) [in Spanish]

    Rev Colomb Neumol

    (2000)
  • MenezesAMB et al.

    Prevalence and risk factors for chronic bronchitis in Pelotas, RS, Brazil: a population-based study

    Thorax

    (1994)

    • Cited by (0)

    This work was performed at Fundación Neumológica Colombiana, Asociación Colombiana de Neumología y Cirugía de Tórax, Bogotá, Colombia.

    The PREPOCOL study was sponsored by an educational contribution from Boehringer-Ingelheim and Pfizer, which did not participate in study design, sample collection, data analysis, or publication. None of the investigators has or has had any contractual relation with the sponsoring companies.

    The authors have no conflicts of interest to disclose.

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    Copyright © 2008 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.