Burden and regional disparities of chronic obstructive pulmonary disease in India: Insights from the global burden of disease data and projections for future incidence.

Vijay Kumar, Mahendra Singh, Mahalaqua Nazli Khatib, Ashok Kumar Balaraman, Rangaswamy Roopashree, Mandeep Kaur, Manish Srivastava, Amit Barwal, G V Siva Prasad, Pranchal Rajput, Rukshar Syed, Gajendra Sharma, Sunil Kumar, Ganesh Bushi, Nagavalli Chilakam, Sakshi Pandey, Manvinder Brar, Rachana Mehta, Sanjit Sah, Muhammed Shabil, Abhay M Gaidhane
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Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally, particularly in low- and middle-income countries like India. This study aims to analyze regional trends and project future burden of COPD in India using data from the Global Burden of Disease (GBD) 1990-2021.

Methods: This analysis utilized data from the GBD study to assess age-standardized prevalence (ASPR), incidence (ASIR), disability-adjusted life years (DALYs) (ASDR), and mortality rates (ASMR) for COPD across Indian states. Joinpoint regression was used to analyze temporal trends, while ARIMA models predicted future incidence rates.

Results: In 2021, the highest ASIR was observed in Rajasthan at 306.28, and the highest ASMR was observed in Uttarakhand at 227.19. Projections suggest that the ASIR for COPD in India will decrease from 265.16 in 2022 to 258.19 by 2031. The heatmap analysis identified states like Uttarakhand and Rajasthan as having the highest DALYs attributable to COPD risk factors, including air pollution and tobacco use.

Conclusion: COPD remains a public health challenge in India, with regional variability. Targeted interventions addressing air pollution, smoking cessation, and improved healthcare access are essential to mitigate the disease's future burden, particularly in high-risk regions.

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印度慢性阻塞性肺疾病的负担和区域差异:来自全球疾病负担数据和未来发病率预测的见解。
背景:慢性阻塞性肺疾病(COPD)是全球发病和死亡的主要原因,特别是在印度等低收入和中等收入国家。本研究旨在利用1990-2021年全球疾病负担(GBD)的数据分析印度COPD的区域趋势和预测未来负担。方法:该分析利用GBD研究的数据来评估印度各州COPD的年龄标准化患病率(ASPR)、发病率(ASIR)、残疾调整生命年(DALYs)和死亡率(ASMR)。接合点回归用于分析时间趋势,而ARIMA模型预测未来发病率。结果:2021年,拉贾斯坦邦ASMR最高,为306.28,北阿坎德邦ASMR最高,为227.19。预测显示,印度COPD的ASIR将从2022年的265.16降至2031年的258.19。热图分析发现,像北阿坎德邦和拉贾斯坦邦这样的邦,由于空气污染和烟草使用等慢性阻塞性肺病风险因素,DALYs最高。结论:慢性阻塞性肺病在印度仍是一项公共卫生挑战,且存在地区差异。针对空气污染、戒烟和改善医疗保健可及性的有针对性干预措施对于减轻该疾病未来的负担至关重要,特别是在高风险地区。
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