title: An epidemiological profile of chronic obstructive pulmonary disease: A community-based study in Delhi.
abstract: BACKGROUND
  Different definitions used for chronic obstructive pulmonary disease (COPD) preclude getting reliable prevalence estimates. Study objective was to find the prevalence of COPD as per standard Global Initiative for Chronic Obstructive Lung Disease definition, risk factors associated, and treatment seeking in adults >30 years.
  
  
  METHODS
  Community-based cross-sectional study was conducted in Delhi, among 1200 adults, selected by systematic random sampling. Pretested questionnaire was used to interview all subjects and screen for symptoms of COPD. Postbronchodilator spirometry was done to confirm COPD.
  
  
  METHODS
  Adjusted odds ratio (aOR) was calculated by multivariable analysis to examine the association of risk factors with COPD. Receiver operating characteristic (ROC) curve was developed to assess predictability.
  
  
  RESULTS
  The prevalence of COPD was 10.1% (95% confidence interval [CI] 8.5, 11.9%). Tobacco smoking was the strongest risk factor associated (aOR 9.48; 95% CI 4.22, 14.13) followed by environmental tobacco smoke (ETS), occupational exposure, age, and biomass fuel. Each pack-year of smoking increased 15% risk of COPD. Ex-smokers had 63% lesser risk compared to current smokers. Clinical allergy seems to preclude COPD (aOR 0.06; 95% CI 0.02, 0.37). ROC analysis showed 94.38% of the COPD variability can be assessed by this model (sensitivity 57.4%; positive predictive value 93.3%). Only 48% patients were on treatment. Treatment continuation was impeded by its cost.
  
  
  CONCLUSIONS
  COPD prevalence in the region of Delhi, India, is high, and our case-finding population study identified a high rate of patients who were not on any treatment. Our study adds to creating awareness on the importance of smoking cessation, early diagnosis of COPD, and the need for regular treatment.
authors.affiliation: Department of Community Medicine, Lady Hardinge Medical College, New Delhi, India.
authors.forename: B
authors.initials: B
authors.lastname: Sinha
authors.affiliation: Department of Community Medicine, Lady Hardinge Medical College, New Delhi, India.
authors.affiliation: Department of TB and Respiratory Diseases, National Institute of TB and Respiratory Diseases, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Singla
authors.affiliation: Department of Community Medicine, R. G. Kar Medical College, Kolkata, West Bengal, India.
authors.forename: R
authors.initials: R
authors.lastname: Chowdhury
mesh_terms: D000328:Adult; D000368:Aged; D055812:Community-Based Participatory Research; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000209:etiology; D012906:Smoke / Q000009:adverse effects*; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data; D014934:Wood
chemical_list: D012906:Smoke; D014028:Tobacco Smoke Pollution