Prevalence of Chronic Obstructive Pulmonary Disease (COPD) in Sri Lankan adults: results of a cross sectional study

This study assessed the prevalence of COPD, its associated risk factors and co-morbidities in Sri Lankan adults.

A cross-sectional study was conducted in 3 rural and 4 urban areas in 7 out of 9 provinces of Sri Lanka using a randomly selected sample of Sri Lankan adults above 18 years. The Burden of Lung Disease (BOLD) survey tool was used with pre- and post-bronchodilator spirometry. Chronic Obstructive Pulmonary Disease (COPD) was classified according to the Global Initiative on Obstructive Lung Disease (GOLD) criteria. The association of COPD with known risk factors: smoking, passive smoking, dusty job, use of firewood; and comorbidities; diabetes mellitus, past history of tuberculosis, hypertension, heart disease, stroke and lung cancer was assessed.

Of 1985 subjects (45.1% male) assessed, the overall prevalence of COPD was 7.3% (95% CI 6.1%-8.4%) and the prevalence among participants above 40 years of age was 10.5% (95% CI 8.9% -12.3%). Among those with COPD, 38.9% was in stage 1, 45.8% in stage 2, 10.4% in stage 3 and 4.9% in stage 4. The prevalence of COPD was significantly higher in males (10.4%) than in females (4.7%). Of the COPD patients, 54.8% were non-smokers. COPD was significantly associated with sex, smoking and exposure to dust among the over-40-year age group. Other known risk factors such as exposure to biomass fumes and a past history of tuberculosis were not significant risk factors in this sample.

The prevalence of COPD in Sri Lankan adults is similar to global figures, is more common in males and the majority had less severe forms of the disease. A considerable proportion of COPD patients were females and non-smokers. Interventions focusing on targeted educational campaigns for risk groups and having facilities for spirometry at primary care level while decreasing the incidence of COPD is likely to improve early detection of the condition.