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COPD: sputum and exacerbations
P121 Feasibility of performing valid spirometry in rural India: preliminary results from a population study assessing the prevalence of COPD
  1. R Mukherjee1,
  2. V C Moore1,
  3. S Purkait2,
  4. P Goon2,
  5. C J Warburton3,
  6. B Chakrabarti3,
  7. P M A Calverley4
  1. 1Department of Respiratory Medicine & Physiology, Birmingham Heartlands Hospital, Birmingham, UK
  2. 2Moitri Swasthya Kendra, Shramajibi Swasthya Udyog, Chengail, West Bengal, India
  3. 3Aintree Chest Centre, University Hospital Aintree, Liverpool, UK
  4. 4Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK

Abstract

Introduction Spirometry remains the cornerstone in the diagnosis of Chronic Obstructive Pulmonary Disease (COPD). Little is known regarding the determinants and prevalence of COPD in rural India. We undertook a population-based study in Howrah District, West Bengal,India at a community-based primary care clinic of a voluntary organisation to test the feasibility of spirometric estimation of the prevalence of COPD.

Methods Spirometry was performed on all adults >35 years attending the clinic. Questionnaire data (capturing respiratory symptoms, occupation, tobacco smoking history, indoor stove use) were gathered for each subject. All spirometric data were examined by an independent UK-based clinical scientist.

Results Spirometry was performed in 315 patients over 3 months; 18% (58/315) of measurements were deemed good quality as per ERS guidelines; 45% (143/315) had the correct shaped curve; hence 64% (201/315) of all spirometries were deemed adequate for FEV1 analysis. Poor quality traces were noted in 36% (n=114) and hence were excluded from analysis. Of the adequate spirometries (n=201, mean age 51 years (SD 12.1); 39% male), 84 (42%) were normal, 102 (51%) exhibited mild airflow obstruction, 12 (6%) moderate airflow obstruction and 3 (1.5%) severe airflow obstruction according to British guidelines. Difference in FEV1% predicted between never/ex smokers and current smokers was significant (p=0.029). Indoor stove use was ubiquitous in this population and did not correlate with FEV1 percent predicted.

Conclusion In a rural Indian setting, valid spirometry can be obtained in two-thirds of adult patients attending a community clinic with 58% of patients in this sample exhibiting at least mild COPD with a history of current smoking being associated with the development of airflow obstruction.

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