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Influence of country-level differences on COPD prevalence
Shawn D Aaron1, Andrea S Gershon2, Yuan Gao1
1Ottawa Hospital Research Institute, University of Ottawa, Ottawa.
Chronic obstructive pulmonary disease (COPD) prevalence varies globally. Country-level factors, beyond individual risks like smoking, significantly influence COPD rates, though some key drivers remain unknown.
Area of Science:
- Epidemiology
- Global Health
- Respiratory Medicine
Background:
- Chronic obstructive pulmonary disease (COPD) prevalence is understood to differ across nations.
- Ecological studies are valuable for examining population-level health trends and risk factors.
Purpose of the Study:
- To investigate the influence of country-level risk factors on the global prevalence of COPD.
- To assess how variations in national socioeconomic development and environmental factors correlate with COPD rates.
Main Methods:
- A systematic review and meta-analysis of 80 English-language articles published between 2003 and 2014.
- Analysis of 1,583 COPD prevalence measures from representative national or subnational populations in 112 districts across 41 countries.
- Stepwise binomial regression was employed to identify associations between study- and country-level factors and COPD prevalence.
Main Results:
- Significant regional variations in COPD prevalence were observed, with lower rates in Australia/New Zealand and the Mediterranean, and higher rates in Latin America compared to North America, Southeast Asia, and Northern Europe.
- While established risk factors (sex, age, smoking) explained 64% of COPD prevalence variability, country-level factors increased explanatory power to 72%.
- High elevation above sea level emerged as a protective factor against COPD, while socioeconomic development showed mixed associations.
Conclusions:
- COPD prevalence exhibits significant geographical variation, even after accounting for individual risk factors.
- Further research is crucial to identify the primary country-level risk factors driving the global COPD epidemic.
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