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Sarno G, Stanisci I, Maio S, Williams S, Ming KE, Diaz SG, Ponte EV, Lan LTT, Soronbaev T, Behera D, Tagliaferro S, Baldacci S, Viegi G. Issue 2 - "Update on adverse respiratory effects of indoor air pollution". Part 2): Indoor air pollution and respiratory diseases: Perspectives from Italy and some other GARD countries. Pulmonology 2023:S2531-0437(23)00083-1. [PMID: 37211526 DOI: 10.1016/j.pulmoe.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/20/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVE to synthesize the Italian epidemiological contribution to knowledge on indoor pollution respiratory impact, and to analyze the perspective of some GARD countries on the health effects of indoor air pollution. RESULTS Italian epidemiological analytical studies confirmed a strong relationship between indoor air pollution and health in general population. Environmental tobacco smoke, biomass (wood/coal) fuel for cooking/heating and indoor allergens (house dust mites, cat and dog dander, mold/damp) are the most relevant indoor pollution sources and are related to respiratory and allergic symptoms/diseases in Italy and in other GARD countries such as Mexico, Brazil, Vietnam, India, Nepal and Kyrgyzstan. Community-based global health collaborations are working to improve prevention, diagnosis and care of respiratory diseases around the world, specially in low- and middle-income countries, through research and education. CONCLUSIONS in the last thirty years, the scientific evidence produced on respiratory health effects of indoor air pollution has been extensive, but the necessity to empower the synergies between scientific community and local administrations remains a challenge to address in order to implement effective interventions. Based on abundant evidence of indoor pollution health effect, WHO, scientific societies, patient organizations and other members of the health community should work together to pursue the GARD vision of "a world where all people breathe freely" and encourage policy makers to increase their engagement in advocacy for clean air.
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Affiliation(s)
- G Sarno
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - I Stanisci
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - S Maio
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - S Williams
- International Primary Care Respiratory Group (IPCRG), 19 Armour Mews, Larbert FK5 4FF, Scotland, United Kingdom
| | - K E Ming
- International Primary Care Respiratory Group (IPCRG), 19 Armour Mews, Larbert FK5 4FF, Scotland, United Kingdom
| | - S G Diaz
- Universidad Autónoma de Nuevo León, Faculty of Medicine and University Hospital "Dr. José Eleuterio González", Regional Center of Allergy and Clinical Immunology, Av. Dr. José Eleuterio González 235, Mitras Centro, 64460 Monterrey, N.L., Mexico
| | - E V Ponte
- Faculdade de Medicina de Jundiaí - Department of Internal Medicine, R. Francisco Teles, 250, Vila Arens II, Jundiaí SP, 13202-550, Brazil
| | - L T T Lan
- University Medical Center, 217 Hong Bang, dist.5, Ho Chi Minh City 17000, Vietnam
| | - T Soronbaev
- Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Togolok Moldo str., Bishkek 720040, Kyrgyzstan
| | - D Behera
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases (NITRD), Sri Aurobindo Marg Near Qutub Minar, Mehrauli, New Delhi 110030, India
| | - S Tagliaferro
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - S Baldacci
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - G Viegi
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy.
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Brakema EA, van der Kleij RMJJ, Poot CC, An PL, Anastasaki M, Crone MR, Hong LHTC, Kirenga B, Lionis C, Mademilov M, Numans ME, Oanh LTT, Tsiligianni I, Sooronbaev T, Walusimbi S, Williams S, Chavannes NH, Reis R. Mapping low-resource contexts to prepare for lung health interventions in four countries (FRESH AIR): a mixed-method study. THE LANCET GLOBAL HEALTH 2022; 10:e63-e76. [DOI: 10.1016/s2214-109x(21)00456-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/20/2021] [Accepted: 09/13/2021] [Indexed: 01/19/2023] Open
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Tabyshova A, Estebesova B, Beishenbekova A, Sooronbaev T, Brakema EA, Chavannes NH, Postma MJ, van Boven JFM. Clinical Characteristics, Treatment Patterns and Economic Burden of COPD in Kyrgyzstan: A FRESH AIR Study. Int J Chron Obstruct Pulmon Dis 2021; 16:2833-2843. [PMID: 34703219 PMCID: PMC8523360 DOI: 10.2147/copd.s322778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND COPD prevalence and mortality in Kyrgyzstan are high. Data on clinical and economic impact of COPD in Kyrgyzstan are scarce. This study was part of the FRESH AIR research project that focused on prevention, diagnosis and treatment of chronic lung diseases in low-resource settings. AIM We aimed to evaluate the clinical characteristics, treatment patterns and economic burden of COPD in Kyrgyzstan. METHODS A representative sample of patients with a spirometry-confirmed diagnosis of COPD was included. All patients were registered in one of the five major hospitals in Kyrgyzstan. Patients were surveyed on COPD risk factors, health-care utilization and patient reported outcomes (CCQ, MRC). Associations with high symptom burden (MRC score ≥4) and cost were assessed using logistic regression analyses. RESULTS A total of 306 patients were included with mean age 62.1 (SD: 11.2), 61.4% being male, mean BMI 26.9 (SD: 5.2) and mean monthly income $85.1 (SD: 75.4). Biomass was used for heating and cooking by 71.2% and 52.0%. Current and ex-smokers accounted 14.1% and 32%. Mean FEV1 was 46% (SD: 12.8), 71.9% had COPD GOLD III-IV and most frequent co-morbidities were hypertension (25.2%), diabetes (5.6%) and heart diseases (4.6%). Mean CCQ score was 2.0 (SD: 0.9) and MRC score 3.7 (SD: 0.9). Yearly mean number of hospital days due to COPD was 10.1 (SD: 3.9). Total annual per-patient costs of reimbursed health-care utilization ($107) and co-payments ($224, ie, 22% of patients' annual income) were $331. We found that only GOLD IV and hypertension were significantly associated with high symptom burden. Exacerbations and hypertension were significantly associated with high cost. CONCLUSION The clinical and economic burden of COPD on patients and the government in Kyrgyzstan is considerable. Notably, almost half of interviewed patients were current or ex-smokers and biomass exposure was high.
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Affiliation(s)
- Aizhamal Tabyshova
- Pulmonology Department, National Center of Cardiology and Internal Medicine Named After M.M. Mirrakhimov, Bishkek, Kyrgyzstan
- Department of Health Sciences, Unit of Global Health, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bermet Estebesova
- Kyrgyz-Russian Slavic University (KRSU), Bishkek, Kyrgyzstan
- Primary Care Center of the Ministry of Internal Affairs, Bishkek, Kyrgyzstan
| | | | - Talant Sooronbaev
- Pulmonology Department, National Center of Cardiology and Internal Medicine Named After M.M. Mirrakhimov, Bishkek, Kyrgyzstan
| | - Evelyn A Brakema
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Maarten J Postma
- Department of Health Sciences, Unit of Global Health, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, The Netherlands
- Department of Pharmacology & Therapy, Airlangga University, Surabaya, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | - Job F M van Boven
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
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