Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries

Autores
Morgan, Brooks W.; Grigsby, Matthew R.; Siddharthan, Trishul; Chowdhury, Muhammad; Rubinstein, Adolfo Luis; Gutierrez, Laura; Irazola, Vilma; Miranda, J. Jaime; Bernabe-Ortiz, Antonio; Alam, Dewan; Wise, Robert A.; Checkley, William
Año de publicación
2019
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) represents the confluence of bronchial airway hyperreactivity and chronic airflow limitation and has been described as leading to worse lung function and quality of life than found with either singular disease process. Objective: We aimed to describe the prevalence and risk factors for ACO among adults across 6 low- and middle-income countries (LMICs). Methods: We compiled cross-sectional data for 11,923 participants aged 35 to 92 years from 4 population-based studies in 12 settings. We defined COPD as postbronchodilator FEV 1 /forced vital capacity ratio below the lower limit of normal, asthma as wheeze or medication use in 12 months or self-reported physician diagnosis, and ACO as having both. Results: The prevalence of ACO was 3.8% (0% in rural Puno, Peru, to 7.8% in Matlab, Bangladesh). The odds of having ACO were higher with household exposure to biomass fuel smoke (odds ratio [OR], 1.48; 95% CI, 0.98-2.23), smoking tobacco (OR, 1.28 per 10 pack-years; 95% CI, 1.22-1.34), and having primary or less education (OR, 1.35; 95% CI, 1.07-1.70) as compared to nonobstructed nonasthma individuals. ACO was associated with severe obstruction (FEV 1 %, <50; 31.6% of ACO vs 10.9% of COPD alone) and severe spirometric deficits compared with participants with asthma (−1.61 z scores FEV 1 ; 95% CI, −1.48 to −1.75) or COPD alone (−0.94 z scores; 95% CI, −0.78 to −1.10). Conclusions: ACO may be as prevalent and more severe in LMICs than has been reported in high-income settings. Exposure to biomass fuel smoke may be an overlooked risk factor, and we favor diagnostic criteria for ACO that include environmental exposures common to LMICs.
Fil: Morgan, Brooks W.. University Johns Hopkins; Estados Unidos
Fil: Grigsby, Matthew R.. University Johns Hopkins; Estados Unidos
Fil: Siddharthan, Trishul. University Johns Hopkins; Estados Unidos
Fil: Chowdhury, Muhammad. International Centre For Diarrhoeal Disease Research ; Bangladesh
Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; Perú
Fil: Bernabe-Ortiz, Antonio. Universidad Peruana Cayetano Heredia; Perú
Fil: Alam, Dewan. University of York; Reino Unido
Fil: Wise, Robert A.. University Johns Hopkins; Estados Unidos
Fil: Checkley, William. University Johns Hopkins; Estados Unidos
Materia
ACO
ASTHMA
ASTHMA-COPD OVERLAP
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
COPD
EPIDEMIOLOGY
HEALTH OUTCOMES
OVERLAP
POPULATION-BASED
RISK FACTORS
SPIROMETRY
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/147465

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oai_identifier_str oai:ri.conicet.gov.ar:11336/147465
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countriesMorgan, Brooks W.Grigsby, Matthew R.Siddharthan, TrishulChowdhury, MuhammadRubinstein, Adolfo LuisGutierrez, LauraIrazola, VilmaMiranda, J. JaimeBernabe-Ortiz, AntonioAlam, DewanWise, Robert A.Checkley, WilliamACOASTHMAASTHMA-COPD OVERLAPCHRONIC OBSTRUCTIVE PULMONARY DISEASECOPDEPIDEMIOLOGYHEALTH OUTCOMESOVERLAPPOPULATION-BASEDRISK FACTORSSPIROMETRYhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) represents the confluence of bronchial airway hyperreactivity and chronic airflow limitation and has been described as leading to worse lung function and quality of life than found with either singular disease process. Objective: We aimed to describe the prevalence and risk factors for ACO among adults across 6 low- and middle-income countries (LMICs). Methods: We compiled cross-sectional data for 11,923 participants aged 35 to 92 years from 4 population-based studies in 12 settings. We defined COPD as postbronchodilator FEV 1 /forced vital capacity ratio below the lower limit of normal, asthma as wheeze or medication use in 12 months or self-reported physician diagnosis, and ACO as having both. Results: The prevalence of ACO was 3.8% (0% in rural Puno, Peru, to 7.8% in Matlab, Bangladesh). The odds of having ACO were higher with household exposure to biomass fuel smoke (odds ratio [OR], 1.48; 95% CI, 0.98-2.23), smoking tobacco (OR, 1.28 per 10 pack-years; 95% CI, 1.22-1.34), and having primary or less education (OR, 1.35; 95% CI, 1.07-1.70) as compared to nonobstructed nonasthma individuals. ACO was associated with severe obstruction (FEV 1 %, <50; 31.6% of ACO vs 10.9% of COPD alone) and severe spirometric deficits compared with participants with asthma (−1.61 z scores FEV 1 ; 95% CI, −1.48 to −1.75) or COPD alone (−0.94 z scores; 95% CI, −0.78 to −1.10). Conclusions: ACO may be as prevalent and more severe in LMICs than has been reported in high-income settings. Exposure to biomass fuel smoke may be an overlooked risk factor, and we favor diagnostic criteria for ACO that include environmental exposures common to LMICs.Fil: Morgan, Brooks W.. University Johns Hopkins; Estados UnidosFil: Grigsby, Matthew R.. University Johns Hopkins; Estados UnidosFil: Siddharthan, Trishul. University Johns Hopkins; Estados UnidosFil: Chowdhury, Muhammad. International Centre For Diarrhoeal Disease Research ; BangladeshFil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; PerúFil: Bernabe-Ortiz, Antonio. Universidad Peruana Cayetano Heredia; PerúFil: Alam, Dewan. University of York; Reino UnidoFil: Wise, Robert A.. University Johns Hopkins; Estados UnidosFil: Checkley, William. University Johns Hopkins; Estados UnidosMosby-Elsevier2019-04info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/147465Morgan, Brooks W.; Grigsby, Matthew R.; Siddharthan, Trishul; Chowdhury, Muhammad; Rubinstein, Adolfo Luis; et al.; Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries; Mosby-Elsevier; Journal of Allergy and Clinical Immunology; 143; 4; 4-2019; 1598-16060091-6749CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://linkinghub.elsevier.com/retrieve/pii/S0091674918313629info:eu-repo/semantics/altIdentifier/doi/10.1016/j.jaci.2018.06.052info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:00:55Zoai:ri.conicet.gov.ar:11336/147465instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:00:55.854CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries
title Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries
spellingShingle Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries
Morgan, Brooks W.
ACO
ASTHMA
ASTHMA-COPD OVERLAP
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
COPD
EPIDEMIOLOGY
HEALTH OUTCOMES
OVERLAP
POPULATION-BASED
RISK FACTORS
SPIROMETRY
title_short Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries
title_full Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries
title_fullStr Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries
title_full_unstemmed Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries
title_sort Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries
dc.creator.none.fl_str_mv Morgan, Brooks W.
Grigsby, Matthew R.
Siddharthan, Trishul
Chowdhury, Muhammad
Rubinstein, Adolfo Luis
Gutierrez, Laura
Irazola, Vilma
Miranda, J. Jaime
Bernabe-Ortiz, Antonio
Alam, Dewan
Wise, Robert A.
Checkley, William
author Morgan, Brooks W.
author_facet Morgan, Brooks W.
Grigsby, Matthew R.
Siddharthan, Trishul
Chowdhury, Muhammad
Rubinstein, Adolfo Luis
Gutierrez, Laura
Irazola, Vilma
Miranda, J. Jaime
Bernabe-Ortiz, Antonio
Alam, Dewan
Wise, Robert A.
Checkley, William
author_role author
author2 Grigsby, Matthew R.
Siddharthan, Trishul
Chowdhury, Muhammad
Rubinstein, Adolfo Luis
Gutierrez, Laura
Irazola, Vilma
Miranda, J. Jaime
Bernabe-Ortiz, Antonio
Alam, Dewan
Wise, Robert A.
Checkley, William
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ACO
ASTHMA
ASTHMA-COPD OVERLAP
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
COPD
EPIDEMIOLOGY
HEALTH OUTCOMES
OVERLAP
POPULATION-BASED
RISK FACTORS
SPIROMETRY
topic ACO
ASTHMA
ASTHMA-COPD OVERLAP
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
COPD
EPIDEMIOLOGY
HEALTH OUTCOMES
OVERLAP
POPULATION-BASED
RISK FACTORS
SPIROMETRY
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) represents the confluence of bronchial airway hyperreactivity and chronic airflow limitation and has been described as leading to worse lung function and quality of life than found with either singular disease process. Objective: We aimed to describe the prevalence and risk factors for ACO among adults across 6 low- and middle-income countries (LMICs). Methods: We compiled cross-sectional data for 11,923 participants aged 35 to 92 years from 4 population-based studies in 12 settings. We defined COPD as postbronchodilator FEV 1 /forced vital capacity ratio below the lower limit of normal, asthma as wheeze or medication use in 12 months or self-reported physician diagnosis, and ACO as having both. Results: The prevalence of ACO was 3.8% (0% in rural Puno, Peru, to 7.8% in Matlab, Bangladesh). The odds of having ACO were higher with household exposure to biomass fuel smoke (odds ratio [OR], 1.48; 95% CI, 0.98-2.23), smoking tobacco (OR, 1.28 per 10 pack-years; 95% CI, 1.22-1.34), and having primary or less education (OR, 1.35; 95% CI, 1.07-1.70) as compared to nonobstructed nonasthma individuals. ACO was associated with severe obstruction (FEV 1 %, <50; 31.6% of ACO vs 10.9% of COPD alone) and severe spirometric deficits compared with participants with asthma (−1.61 z scores FEV 1 ; 95% CI, −1.48 to −1.75) or COPD alone (−0.94 z scores; 95% CI, −0.78 to −1.10). Conclusions: ACO may be as prevalent and more severe in LMICs than has been reported in high-income settings. Exposure to biomass fuel smoke may be an overlooked risk factor, and we favor diagnostic criteria for ACO that include environmental exposures common to LMICs.
Fil: Morgan, Brooks W.. University Johns Hopkins; Estados Unidos
Fil: Grigsby, Matthew R.. University Johns Hopkins; Estados Unidos
Fil: Siddharthan, Trishul. University Johns Hopkins; Estados Unidos
Fil: Chowdhury, Muhammad. International Centre For Diarrhoeal Disease Research ; Bangladesh
Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; Perú
Fil: Bernabe-Ortiz, Antonio. Universidad Peruana Cayetano Heredia; Perú
Fil: Alam, Dewan. University of York; Reino Unido
Fil: Wise, Robert A.. University Johns Hopkins; Estados Unidos
Fil: Checkley, William. University Johns Hopkins; Estados Unidos
description Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) represents the confluence of bronchial airway hyperreactivity and chronic airflow limitation and has been described as leading to worse lung function and quality of life than found with either singular disease process. Objective: We aimed to describe the prevalence and risk factors for ACO among adults across 6 low- and middle-income countries (LMICs). Methods: We compiled cross-sectional data for 11,923 participants aged 35 to 92 years from 4 population-based studies in 12 settings. We defined COPD as postbronchodilator FEV 1 /forced vital capacity ratio below the lower limit of normal, asthma as wheeze or medication use in 12 months or self-reported physician diagnosis, and ACO as having both. Results: The prevalence of ACO was 3.8% (0% in rural Puno, Peru, to 7.8% in Matlab, Bangladesh). The odds of having ACO were higher with household exposure to biomass fuel smoke (odds ratio [OR], 1.48; 95% CI, 0.98-2.23), smoking tobacco (OR, 1.28 per 10 pack-years; 95% CI, 1.22-1.34), and having primary or less education (OR, 1.35; 95% CI, 1.07-1.70) as compared to nonobstructed nonasthma individuals. ACO was associated with severe obstruction (FEV 1 %, <50; 31.6% of ACO vs 10.9% of COPD alone) and severe spirometric deficits compared with participants with asthma (−1.61 z scores FEV 1 ; 95% CI, −1.48 to −1.75) or COPD alone (−0.94 z scores; 95% CI, −0.78 to −1.10). Conclusions: ACO may be as prevalent and more severe in LMICs than has been reported in high-income settings. Exposure to biomass fuel smoke may be an overlooked risk factor, and we favor diagnostic criteria for ACO that include environmental exposures common to LMICs.
publishDate 2019
dc.date.none.fl_str_mv 2019-04
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/147465
Morgan, Brooks W.; Grigsby, Matthew R.; Siddharthan, Trishul; Chowdhury, Muhammad; Rubinstein, Adolfo Luis; et al.; Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries; Mosby-Elsevier; Journal of Allergy and Clinical Immunology; 143; 4; 4-2019; 1598-1606
0091-6749
CONICET Digital
CONICET
url http://hdl.handle.net/11336/147465
identifier_str_mv Morgan, Brooks W.; Grigsby, Matthew R.; Siddharthan, Trishul; Chowdhury, Muhammad; Rubinstein, Adolfo Luis; et al.; Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries; Mosby-Elsevier; Journal of Allergy and Clinical Immunology; 143; 4; 4-2019; 1598-1606
0091-6749
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
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info:eu-repo/semantics/altIdentifier/doi/10.1016/j.jaci.2018.06.052
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
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application/pdf
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dc.publisher.none.fl_str_mv Mosby-Elsevier
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repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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