Department of Medicine, Division of Allergy and Pulmonary Medicine, S.M.S. Medical College, Jaipur, Rajasthan, India.
Department of Respiratory Medicine, Lung Center, Rajasthan Hospital, Jaipur, Rajasthan, India.
PLoS One. 2022 Aug 18;17(8):e0268216. doi: 10.1371/journal.pone.0268216. eCollection 2022.
The Global Burden of Disease data suggest that respiratory diseases contribute to high morbidity in India. However, the factors responsible for high morbidity are not quite clear. Therefore, the Seasonal Waves Of Respiratory Disorders (SWORD) study was planned to estimate the point prevalence due to respiratory diseases in Indian OPD services and its association with risk factors and change in seasons.
In this point prevalence observational multicenter study conducted during 2017-18, participating physicians recorded information of consecutive patients in response to a questionnaire. The study was conducted on four predetermined days representing transition of Indian seasons i.e., February (winter), May (summer), August (monsoon), and November (autumn).
The eligible number of patients from across 302 sites in India was 25,177. The mean age of study population was 46.1±18.1 years, 14102(56.0%) were males and 11075(44.0%) females. The common diagnoses were: asthma(29.8%), chronic obstructive pulmonary disease (COPD),15.6%, respiratory tract infections (RTIs),11.3%, and tuberculosis(8.7%). All these conditions showed significant seasonal trends (Asthma 31.4% autumn vs. 26.5% summer, COPD 21.1% winter vs. 8.1% summer, RTIs 13.3% winter vs. 4.3% summer, and tuberculosis 12.5% autumn vs. 4.1% summer, p<0.001 for each respectively). After adjustment for risk factors, asthma was significantly associated with exposure to molds (OR:1.12,CI:1.03-1.22), pet animals (OR:1.07,CI:1.01-1.14), recent-travel (OR:1.22,CI:1.13-1.32), and rain-wetting (OR:1.27,CI:1.15-1.40); and RTIs with rain-wetting (OR:1.53,CI:1.34-1.74), and recent-travel (OR:1.17,CI:1.05-1.30).
The SWORD study showed wide seasonal variations in outpatient attendance of patients with common respiratory conditions. Novel risk-factors associated with respiratory diseases were also identified.
全球疾病负担数据表明，呼吸疾病在印度导致高发病率。然而，导致高发病率的因素尚不清楚。因此，计划进行季节性呼吸障碍波（SWORD）研究，以估计印度门诊服务中呼吸疾病的时点患病率及其与危险因素和季节变化的关系。
在这项于 2017-18 年进行的时点患病率观察性多中心研究中，参与的医生根据问卷记录连续患者的信息。该研究在印度四个预定的日子进行，代表印度季节的过渡，即 2 月（冬季）、5 月（夏季）、8 月（季风期）和 11 月（秋季）。
从印度 302 个地点的合格患者人数为 25177 人。研究人群的平均年龄为 46.1±18.1 岁，14102 人（56.0%）为男性，11075 人（44.0%）为女性。常见诊断包括：哮喘（29.8%）、慢性阻塞性肺疾病（COPD）（15.6%）、呼吸道感染（RTIs）（11.3%）和结核病（8.7%）。所有这些疾病都显示出明显的季节性趋势（哮喘：31.4%秋季比 26.5%夏季，COPD：21.1%冬季比 8.1%夏季，RTIs：13.3%冬季比 4.3%夏季，结核病：12.5%秋季比 4.1%夏季，p<0.001 分别）。在调整危险因素后，哮喘与接触霉菌（OR：1.12，CI：1.03-1.22）、宠物动物（OR：1.07，CI：1.01-1.14）、近期旅行（OR：1.22，CI：1.13-1.32）和雨淋（OR：1.27，CI：1.15-1.40）显著相关；RTIs 与雨淋（OR：1.53，CI：1.34-1.74）和近期旅行（OR：1.17，CI：1.05-1.30）显著相关。
SWORD 研究表明，常见呼吸疾病患者的门诊就诊存在广泛的季节性变化。还确定了与呼吸疾病相关的新危险因素。
