McKay Ailsa J, Mahesh P A, Fordham Julia Z, Majeed Azeem
Imperial College School of Medicine, Imperial College London, London, UK.
Prim Care Respir J. 2012 Sep;21(3):313-21. doi: 10.4104/pcrj.2012.00055.
The increasing burden of chronic diseases is a particular risk to countries with developing health systems. Chronic obstructive pulmonary disease (COPD) is contributing to the burden of chronic diseases. Understanding the current prevalence of COPD in India is important for the production of sustainable management strategies.
To provide a systematic review of studies assessing the prevalence of COPD in India.
Database searches, journal hand searches, and scanning of reference lists were used to identify studies. Studies of general adult populations resident in India were included. Data extraction and quality assessment were carried out using pre-tested proformas. Owing to the heterogeneity of reviewed studies, meta-analysis was not appropriate. Thus, narrative methods were used.
We did not identify any studies from which we could draw a rigorous estimate of the prevalence of COPD by standard definition. Reliable standard estimates of chronic bronchitis were only available for rural populations. We identified four studies that gave estimated prevalences between 6.5% and 7.7%, and others suggestive that prevalences in some environmentally atypical regions may lie outside this range. Sex and smoking status were relatively important predictors of COPD prevalence. Residential environs, age, and domestic smoke exposure are also important, but investigation of their effect was limited by study heterogeneity.
Although limited by the number and heterogeneity of studies and their unsuitability for meta-analysis, we found the most rigorous existing estimates of the general prevalence of chronic bronchitis in rural areas to lie between 6.5% and 7.7%. These figures are unlikely to apply to all Indian subpopulations, so the general prevalence of chronic bronchitis in India remains unknown. Accurate estimates of the prevalence of chronic bronchitis/COPD from across the country are required to supplement existing data if optimal management strategies are to be devised.
慢性病负担日益加重，对卫生系统尚在发展的国家构成了特殊风险。慢性阻塞性肺疾病（COPD）加重了慢性病的负担。了解印度COPD的当前患病率对于制定可持续管理策略至关重要。
对评估印度COPD患病率的研究进行系统综述。
通过数据库检索、期刊手工检索以及查阅参考文献列表来识别研究。纳入针对居住在印度的一般成年人群的研究。使用预先测试的表格进行数据提取和质量评估。由于所综述研究的异质性，不适合进行荟萃分析。因此，采用叙述性方法。
我们未找到任何能依据标准定义对COPD患病率进行严格估计的研究。仅农村人口有慢性支气管炎的可靠标准估计值。我们确定了四项研究，其估计患病率在6.5%至7.7%之间，其他研究表明在一些环境非典型地区患病率可能超出此范围。性别和吸烟状况是COPD患病率相对重要的预测因素。居住环境、年龄和家庭烟雾暴露也很重要，但对其影响的研究因研究异质性而受限。
尽管受研究数量、异质性及其不适合进行荟萃分析的限制，但我们发现农村地区慢性支气管炎总体患病率最严格的现有估计值在6.5%至7.7%之间。这些数字不太可能适用于所有印度亚人群体，因此印度慢性支气管炎的总体患病率仍然未知。若要制定最佳管理策略，需要对全国慢性支气管炎/COPD患病率进行准确估计以补充现有数据。
