Abstract
Background: Poverty is an important surrogate marker for obstructive airway diseases (OAD). Slum constitutes a habitat wherein various poverty related parameters are perpetually prevalent in the ambience. 1/6th of world population lives in slums yet there is no information regarding their health status in context to asthma and COPD. Aims: We investigated the prevalence of asthma and chronic-bronchitis symptoms and associated risk-factors in slum habitats of Pune city. Methodology: 7062 adult slum-dwellers living in 12 slums of Pune city were cross-sectionally interviewed by local healthcare workers with respiratory health questionnaire which was designed using respiratory symptoms of validated European Community Respiratory Health Survey (ECRHS II) questionnaire and International Union against Tuberculosis and Lung Disease (IUATLD) bronchial symptoms questionnaire. Results: The overall prevalence of selfreported asthma symptoms was 10% (18 - 40 years: 6.5%; >40 years: 13.5%). The overall prevalence of chronic bronchitis was 8.5% [18 - 40 years: 7% (males: 7%, females: 7%); >40 years: 10% (males: 10%, females: 10%)]. Increasing age (p = 0.00), female gender (p = 0.001), unemployment (0.00) current smoking (p = 0.00) and ex-smoking (p = 0.004) emerged as significant risk factor for asthma. While, ex-smoking (p = 0.004) and low-education status (p = 0.00) emerged as significant risk factors for chronic bronchitis. Conclusion: In slums reporting of asthma and chronic-bronchitis symptoms was much higher than what has been reported earlier from India. Asthma was commonly seen in females, old age, unemployed and ever-smokers. While chronic bronchitis was commonly seen in ex-smokers and illiterate subjects. Chronic bronchitis was equally distributed amongst male and females, despite 0% prevalence of smoking in females.
Highlights
Non-communicable respiratory morbidities such as asthma and COPD are rapidly rising to emerge as leading causes of mortality worldwide
This study investigated the prevalence of asthma and chronic bronchitis amongst the slum dwellers of Pune city and risk-factors associated with them using a respiratory-health questionnaire
+Adjusted for: Age, smoking status, education status, * = p < 0.05, ** = p < 0.01. This is the first study which has investigated the prevalence of respiratory symptoms in context to asthma and chronic-bronchitis in more than 7000 adult slum dwellers, and has shown high prevalence of these respiratory morbidities in the slum community
Summary
Non-communicable respiratory morbidities such as asthma and COPD are rapidly rising to emerge as leading causes of mortality worldwide. There has been a sharp rise in urban settlements of poor called slums in various cities of developing countries [6,7]. This demographic trend is an outcome of rapid economic development causing migration of rural communities to urban establishments primarily in search of better livelihood. Aims: We investigated the prevalence of asthma and chronic-bronchitis symptoms and associated risk-factors in slum habitats of Pune city. Ex-smoking (p = 0.004) and low-education status (p = 0.00) emerged as significant risk factors for chronic bronchitis. Chronic bronchitis was distributed amongst male and females, despite 0% prevalence of smoking in females
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