Etiology and epidemiology of acute exacerbations of chronic obstructive pulmonary disease in Eastern Nepal: a narrative review

Abstract

This narrative review aims to examine the etiology and epidemiology of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in Eastern Nepal. A systematic search was conducted to identify relevant studies published in English, focusing on combinations of keywords such as “acute exacerbation of chronic obstructive pulmonary disease,” “AECOPD,” “Nepal,” “etiology,” “epidemiology,” “environmental exposure,” “comorbidities,” and “socioeconomic factors.” Synthesizing findings from recent studies, it highlights the multifactorial nature of AECOPD, including the roles of respiratory infections, environmental exposures, and comorbidities. Key findings indicate that respiratory infections (both viral and bacterial) and non-infectious factors such as air pollution and biomass fuel combustion significantly contribute to AECOPD. Socio-economic factors, particularly among women using traditional biomass fuels and engaged in smoking, also play a critical role. The review emphasizes the need for targeted interventions and preventive strategies to manage AECOPD effectively in this region. Conclusions suggest that understanding local patterns of AECOPD etiology is crucial for developing region-specific interventions to reduce exposure to risk factors and manage comorbidities, thereby improving clinical outcomes and reducing healthcare utilization.