Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study.
BACKGROUND
Both the prevalence and mortality attributable to chronic obstructive pulmonary disease (COPD) seem to be increasing in low-income and middle-income countries, but few data are available. The aim of the PLATINO study, launched in 2002, was to describe the epidemiology of COPD in five major Latin American cities: São Paulo (Brazil), Santiago (Chile), Mexico City (Mexico), Montevideo (Uruguay), and Caracas (Venezuela).


METHODS
A two-stage sampling strategy was used in the five areas to obtain probability samples of adults aged 40 years or older. These individuals were invited to answer a questionnaire and undergo anthropometry, followed by prebronchodilator and postbronchodilator spirometry. We defined COPD as a ratio less than 0.7 of postbronchodilator forced expiratory volume in the first second over forced vital capacity.


RESULTS
Complete information, including spirometry, was obtained from 963 people in São Paulo, 1173 in Santiago, 1000 in Mexico City, 885 in Montevideo, and 1294 in Caracas. Crude rates of COPD ranged from 7.8% (78 of 1000; 95% CI 5.9-9.7) in Mexico City to 19.7% (174 of 885; 17.2-22.2) in Montevideo. After adjustment for key risk factors, the prevalence of COPD in Mexico City remained significantly lower than that in other cities.


CONCLUSIONS
These results suggest that COPD is a greater health problem in Latin America than previously realised. Altitude may explain part of the difference in prevalence. Given the high rates of tobacco use in the region, increasing public awareness of the burden of COPD is important.
Menezes
Ana Maria B
AM
Universidade Federal de Pelotas, Pelotas, Brazil. anamene@terra.com.br
Perez-Padilla
Rogelio
R
Jardim
José Roberto B
JR
Muiño
Adriana
A
Lopez
Maria Victorina
MV
Valdivia
Gonzalo
G
Montes de Oca
Maria
M
Talamo
Carlos
C
Hallal
Pedro C
PC
Victora
Cesar G
CG
D000328:Adult; D005260:Female; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D012129:Respiratory Function Tests; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014505:Urban Population