Chronic obstructive pulmonary disease (COPD)

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Chronic obstructive pulmonary disease (COPD):

Chronic obstructive pulmonary disease (COPD) Complied by: Jeevan Acharya B.P.H; Nepal

Introduction :

Introduction COPD has been defined as a disease stage characterized by airflow limitation that is not fully reversible. It includes: Emphysema: Destruction of airways distal to the terminal bronchiole. Chronic bronchitis: Excessive mucus production with airway obstruction and notable hyperplasia of mucus-producing glands .

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August 28, 2012

COPD inflammation is different from asthma inflammation:

COPD inflammation is different from asthma inflammation Asthma Eosinophils CD4+ T-lymphocytes Mast cells Reversible Sensitising agent Inflammatory cells COPD Neutrophils CD8+ T-lymphocytes Macrophages Noxious agent Not fully reversible Airflow limitation Onset 1. From the Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2009. Available from:


Epidemiology The prevalence rates are about 5% for male and 2.7% for female subjects over 30 years. Male : female :: 1.6 : 1 COPD affects 210 million people worldwide and causes 3 million deaths annually ( 5% of all deaths worldwide) 2 . It is predicted to become the third leading cause of global mortality by 2030 3 . 2. WHO, 2009. 3. WHO, 2010.

Epidemiology of COPD in Nepal :

Epidemiology of COPD in Nepal COPD in Kathmandu valley has increased definitely by more than 70%. 4 Panday et al (1984): A cross sectional study of 2826 adults in rural hilly region of Nepal was done and found that the prevalence of COPD was 18.3%, similar in men and women. 4. [Hospital data of TUTH, Bir Hospital, Patan Hospital]


Cont…. In the fiscal year 2061/2062, COPD was the 8 th common cause for OPD visits 7 th common cause for hospitalization. The highest mortality and morbidity among the hospitalized patients in Bir hospital was from COPD. In FY 2062/63, COPD was still the leading cause of mortality in Bir hospital but in morbidity head injury has exceeded it.


Cont… The Rate of incidence in Nepal of COPD is highest in the world, an estimated 79% of Nepali men and 58% of Nepali women smoke. 5 5. [ Jan 13, 1984 Rising Nepal]

No. of COPD Patients in Major Hospitals:

No. of COPD Patients in Major Hospitals No of COPD patients increasing, specially over the past 5 years

COPD Patients as % of Total Medical Patients Discharged from Major Hospitals:

COPD Patients as % of Total Medical Patients Discharged from Major Hospitals % of COPD Patients Increasing Slightly in the Past Five Years

COPD Patients in 2059 (2001/02):

COPD Patients in 2059 (2001/02) No. of COPD Patients is Higher in the Winter Months

Epidemiological Factors of COPD:

Epidemiological Factors of COPD Risk factor for COPD Tobacco smoke (including second-hand or passive exposure) Indoor air pollution, such as the use of biomass fuels for cooking and heating Outdoor air pollution , such as transport section and industrial sectors brick, cement factories. Other risk factors for COPD include occupational dusts and chemicals (such as vapors, irritants, and fumes) and frequent lower respiratory infections during childhood.


Cont… B. Host factors : COPD is more prevalent among those people with lack of Alpha antitrypsin enzyme. Old age populations are more vulnerable. Children may suffer from intrinsic asthmatic attack and may subject to status asthmatics. C. Environment factors: Cold, dusty environment aggravate the incidence and prevalence of COPD

Symptoms :

Symptoms COPD is a group of illness, present with various symptoms and signs. Breathlessness, or a 'need for air' excessive sputum production, Chronic cough. Paroxysmal Nocturnal Dyspnoea Cyanosed Tracheal Tug Barrel shaped chest Tachypnoea


Transmissibility Non transmissible; If infected by invasive organisms, infection may be transmitted however COPD is not.

Diagnosis and treatment:

Diagnosis and treatment A simple diagnostic test called "spirometry“ COPD is not curable. Various forms of treatment can help control its symptoms and increase quality of life for people with the illness. For example, medicines that help dilate major air passages of the lungs can improve shortness of breath.

 WHO strategies for the prevention and control of COPD:

WHO strategies for the prevention and control of COPD Raise awareness about the global epidemic of chronic diseases; Create more healthy environments, especially for poor and disadvantaged populations; Decrease common chronic disease risk factors, such as tobacco use, unhealthy diet and physical inactivity; Prevent premature deaths and avoidable disabilities from major chronic diseases .

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August 28, 2012 Thank you

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