Diagnosis, control and prevention of chronic obstructive pulmonary disease among middle-aged and elderly residents in Anhui province

  Objective  To investigate current situation of diagnosis, control and prevention of chronic obstructive pulmonary disease (COPD) among middle-aged and elderly residents in Anhui province for providing evidences to COPD prevention and control.

  Methods  Using stratified multistage cluster random sampling, we recruited 2 996 residents aged ≥ 40 years at 5 COPD surveillance sites across Anhui province and conducted a questionnaire survey and physical examination among the participants during January – June, 2015. For the diagnosis of COPD, lung function measurement before and after bronchial dilation test were performed among 2 815 participants without relevant contraindications.

  Results  Totally 272 COPD patients were diagnosed among all participants undergoing lung function testing. Among the COPD patients diagnosed, the prevalence rates of previously diagnosed diseases were 15.5% for chronic bronchitis, 4.1% for emphysema, 6.3% for asthma, 0.4% for previously diagnosed COPD, and 18.2% for other chronic respiratory diseases; among the patients with previously diagnosed chronic bronchitis, emphysema, asthma, and chronic respiratory diseases, the detection rate of COPD were 33.1%, 55.0%, 33.3%, and 31.8%; the COPD detection rate was positively correlated with previous history of chronic bronchitis, emphysema, asthma, and chronic respiratory diseases, with the correlation coefficients of 0.17, 0.13, 0.11, and 0.18 (all P < 0.001) and the Kappa values of 0.16, 0.06, 0.08, and 0.17, respectively. Of all the participants, only 2.0% (51) reported previous lung function testing; 28.3% (843) and 25.2% (758) were current and daily smokers and the prevalence rate of current and daily smoking were significantly higher among the participants with chronic respiratory diseases (42.0% vs. 27.3% and 39.2% vs. 24.2%), respiratory disease symptoms (34.2% vs. 27.5% and 33.2% vs. 24.2%), and COPD detected in lung function testing (53.6% vs. 25.4% and 48.4% vs. 22.6%) compared with the participants without those diseases or symptoms (all P < 0.001).

  Conclusion  Among middle-aged and elderly residents in Anhui province, the missed diagnosis of COPD is prevalent; the rate of having lung function testing is low; and the smoking rate is high among the residents with chronic respiratory diseases and symptoms.