Background: Despite chronic obstructive pulmonary disease (COPD) being the commonest non-communicable disease in Nepal, there is limited research evidence estimating the spirometry-based burden of COPD. This study aims to estimate the prevalence of COPD and its correlates through a community-based survey in Pokhara Metropolitan City, a semiurban area of Western Nepal. Methods: A cross-sectional household survey was conducted among 1459 adults ≥40 years. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria as a post-bronchodilator ratio of forced expiratory volume in 1st second (FEV 1) to forced vital capacity (FVC) <0.70 with the presence of symptoms. COPD was also defined by the lower limit of normal (LLN) threshold-FEV 1 /FVC < LLN cutoff values with the presence of symptoms. Study participants were interviewed about sociodemographic and behavioural characteristics and respiratory symptoms. Descriptive statistics and logistic regression analysis were applied. Results: Spirometry reports were acceptable in 1438 participants. The mean age of the participants was 55 (±10) years, and, 54% were female. The prevalence of GOLD-defined COPD was 8.5% (95% CI: 7.1-10.0) and based on the LLN threshold of 5.4% (95% CI: 4.2-6.6). The multivariate logistic regression showed that increasing age, low body mass index, illiterate, current or former smoker, and biomass fuel smoke increased the odds of COPD in both the definitions. Conclusion: COPD is highly prevalent at community level and often underdiagnosed. Strategies aiming at early diagnosis and treatment of COPD, especially for the elderly, illiterate, and reducing exposure to smoking and biomass fuel smoke and childhood lung infection could be effective.
Aim: Recent studies suggest insect declines in parts of Europe; however, the generality of these trends across different taxa and regions remains unclear. Standardized data are not available to assess large-scale, long-term changes for most insect groups but opportunistic citizen science data are widespread for some. Here, we took advantage of citizen science data to investigate distributional changes of Odonata.Location: Germany.
Methods:We compiled over 1 million occurrence records from different regional databases. We used occupancy-detection models to account for imperfect detection and estimate annual distributions for each species during 1980-2016 within 5 × 5 kmThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Recent studies suggest insect declines in parts of Europe; however, the generality of these trends across different taxa and regions remains unclear. Standardized data are not available to assess large-scale, long-term changes for most insect groups but opportunistic citizen science data is widespread for some taxa. We compiled over 1 million occurrence records of Odonata (dragonflies and damselflies) from different regional databases across Germany. We used occupancy-detection models to estimate annual distributional changes between 1980 and 2016 for each species. We related species attributes to changes in the species distributions and inferred possible drivers of change. Species showing increases were generally warm-adapted species and/or running water species while species showing decreases were cold-adapted species using standing water habitats such as bogs. We developed a novel approach using time-series clustering to identify groups of species with similar patterns of temporal change. Using this method, we defined five typical patterns of change for Odonata, each associated with a specific combination of species attributes. Overall, trends in Odonata provide mixed news since improved water quality, coupled with positive impacts of climate change, could explain the positive trend status of many species. At the same time, declining species point to conservation challenges associated with habitat loss and degradation. Our study demonstrates the great value of citizen science data for assessing large-scale distributional change and conservation decision-making.
tIgE levels, FNO and AEC levels are higher in asthma, specifically in the atopic phenotype, as compared to normal. Total serum IgE levels have moderate correlation with FNO and AEC but FNO and AEC are weakly correlated.
Background
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide and the commonest of non-communicable diseases (NCDs) in Nepal. Risk factors like indoor and outdoor air pollution, a high prevalence of smoking, and the lack of awareness of COPD make it a serious public health concern. However, no attempt has been made in Nepal to estimate its burden and address the disease at the community level.
Method
This study aims to evaluate the effect of a community-based health educational intervention administered by Female Community Health Volunteers (FCHVs) on the prevention and management of COPD. An open-label, two-group, community-based, cluster-randomized controlled trial will be implemented in the semi-urban area of Pokhara Metropolitan city (former Lekhnath Municipality) located in the Kaski district of Nepal. The estimated sample size of the intervention will be 1143. The unit of randomization is the ward (administrative unit) of the study area. The follow-up survey will be conducted immediately after 12 months of FCHVs-led interventions. The difference in the rate of decline of forced expiratory volume in 1 s (FEV1) and FEV1/FVC (forced vital capacity) ratio are the primary outcomes and the change in the proportion of modifiable risk factors of COPD, health-related quality of life scores, and change in knowledge of COPD will be secondary outcomes.
Discussion
This study will estimate the burden of COPD, the magnitude of risk factors and generate evidence to mobilize community health workers for COPD prevention and management at the community level in Nepal.
Trial registration
ClinicalTrials.gov NCT03797768. Registered on January 9, 2019.
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