Epidemiology of Chronic Obstructive Pulmonary Disease in Brazil: a systematic review and meta-analysis

Duarte

2021

Preprint

Background: Understanding the patterns of rehabilitation therapies among individuals who need them in Brazil can help identify the most vulnerable populations and guide public policies. We aim to analyze the use of rehabilitation therapies among Brazilian adults with chronic conditions and limitations in their daily activities. Methods: This is a population-based survey with data from the 2013 National Health Survey, whose complex sample consisted of three-stage clusters. The outcome considered was the adult population who reported a stroke, arthritis, work-related musculoskeletal disorder (WMSD), chronic obstructive pulmonary disease (COPD), or reported back pain, associated with moderate to very intense limitations of their activities and who have used rehabilitation therapies. A logistic regression model was estimated, with a 95%CI, adjusted for sociodemographic variables. Results: Among Brazilian adults, 24.8% were diagnosed with a stroke, arthritis, WMSD, COPD, or reported back pain. Among these, 34.6% reported having moderate, intense, or very intense limitations in their daily activities due to illnesses, and, among this population, 26.3% performed some rehabilitation therapy related to their conditions. The use of rehabilitation therapies was more frequent among the female population, with higher education, higher socioeconomic status, older, and living in the southern macro-region of Brazil. Conclusions: the low frequency of rehabilitation therapies may be associated with barriers to access health services.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors Associated With The Use of Rehabilitation Therapies Among Brazilian Adults With Chronic Diseases And Functional Limitations: A Cross-Seccional Study

Duarte

2021

Preprint

“…Alterações da mecânica pulmonar resultam nas principais manifestações clínicas de dispneia, tosse e expectoração crônica. (2,3) A DPOC aumenta a suscetibilidade a distúrbios do sono. A predisposição ao sono de má qualidade em pacientes com DPOC possivelmente ocorre em virtude de anormalidades das vias aéreas superiores e inferiores.…”

Section: Introductionunclassified

Sleep quality in COPD patients: correlation with disease severity and health status

et al. 2022

Objective: To evaluate clinical predictors of poor sleep quality in COPD patients with and without obstructive sleep apnea (OSA). Methods: Consecutive stable patients with COPD were evaluated for OSA by means of overnight polysomnography; for sleep quality by means of the Pittsburgh Sleep Quality Index (PSQI); and for disease impact by means of the COPD Assessment Test. COPD severity was graded in accordance with the 2020 GOLD guidelines. Predictors of poor sleep quality were evaluated by multivariate logistic regression analysis. Results: We studied 51 patients with COPD alone and 51 patients with COPD and OSA. Both groups had similar age (66.2 ± 9.2 years vs. 69.6 ± 10.7, p = 0.09) and airflow limitation (p = 0.37). Poor sleep quality was present in 74.8% of the study participants, with no significant difference between COPD patients with and without OSA regarding PSQI scores (p = 0.73). Polysomnography showed increased stage 1 non-rapid eye movement sleep and arousal index, as well as reduced sleep efficiency and stage 3 non-rapid eye movement sleep, in the group of patients with COPD and OSA (p < 0.05). Independent predictors of poor sleep quality were GOLD grade C/D COPD (OR = 6.4; 95% CI, 1.79-23.3; p < 0.01), a COPD Assessment Test score = 10 (OR = 12.3; 95% CI, 4.1-36.5; p < 0.01), and lowest SaO2 < 80% (p < 0.0001). Conclusions: Poor sleep quality is quite common in patients with COPD and is associated with severe COPD and poor health status, having a negative impact on overall quality of life. Despite changes in polysomnography, OSA appears to have no impact on subjective sleep quality in COPD patients. Keywords: Pulmonary disease, chronic obstructive; Sleep Quality; Sleep apnea, obstructive; Health status.

“…Asthma and COPD have multifactorial causes and are associated with exposure factors related to the occupational or home environment (tobacco and wood smoke), unfavorable socioeconomic status, and genetic factors [7][8][9][10] . According to the literature, air polluting agents are related to lung diseases and respiratory symptoms 11 .…”

Section: Introductionmentioning

confidence: 99%

Chronic respiratory diseases and respiratory symptoms after a mining dam rupture: Brumadinho Health Project

Nascimento-Souza

Monteiro

Firmo

et al. 2022

Rev. bras. epidemiol.

Objective: To identify factors associated with asthma and chronic obstructive pulmonary disease (COPD) and respiratory symptoms, in Brumadinho, state of Minas Gerais, Brazil, after a dam rupture. Methods: This is a cross-sectional study, including a representative sample of adults (aged 18 years and over) in the municipality. Associations were assessed between dependent variables (medical diagnosis of asthma and COPD; symptoms of wheezing, dry cough, and nose irritation) and exploratory variables (sex, age group, smoking habit, having worked at Vale S.A. company before the dam rupture, time and area of residence in relation to the dam rupture). Logistic regression models with odds ratio (OR) calculation and 95% confidence interval were used. Results: We identified a prevalence of 7.2% of asthma; 3.5% of COPD; 8.8% of wheezing; 23.6% of dry cough; and 31.8% of nose irritation. We observed a greater chance of asthma among women and residents in the affected and mining regions, while a greater chance of COPD was observed in smokers and in those with longer time of residence in the municipality. Among the symptoms, we verified a higher chance of nose irritation among women, while a higher chance of wheezing and dry cough were found among smokers (current and former). Residents of regions affected by the mud reported a greater chance of presenting all the analyzed symptoms. Conversely, level of education was negatively associated with wheezing and dry cough. Conclusion: We found respiratory changes and identified the groups most vulnerable to developing them, which could contribute to directing actions to reduce the population’s respiratory problems.