Proportionate clinical burden of respiratory diseases in Indian outdoor services and its relationship with seasonal transitions and risk factors: The results of SWORD survey

Abstract

Background The Global Burden of Disease data suggest that respiratory diseases contribute to high morbidity in India. However, the factors responsible for high morbidity are not quite clear. Therefore, the Seasonal Waves Of Respiratory Disorders (SWORD) study was planned to estimate the point prevalence due to respiratory diseases in Indian OPD services and its association with risk factors and change in seasons. Methods In this point prevalence observational multicenter study conducted during 2017–18, participating physicians recorded information of consecutive patients in response to a questionnaire. The study was conducted on four predetermined days representing transition of Indian seasons i.e., February (winter), May (summer), August (monsoon), and November (autumn). Results The eligible number of patients from across 302 sites in India was 25,177. The mean age of study population was 46.1±18.1 years, 14102(56.0%) were males and 11075(44.0%) females. The common diagnoses were: asthma(29.8%), chronic obstructive pulmonary disease (COPD),15.6%, respiratory tract infections (RTIs),11.3%, and tuberculosis(8.7%). All these conditions showed significant seasonal trends (Asthma 31.4% autumn vs. 26.5% summer, COPD 21.1% winter vs. 8.1% summer, RTIs 13.3% winter vs. 4.3% summer, and tuberculosis 12.5% autumn vs. 4.1% summer, p<0.001 for each respectively). After adjustment for risk factors, asthma was significantly associated with exposure to molds (OR:1.12,CI:1.03–1.22), pet animals (OR:1.07,CI:1.01–1.14), recent-travel (OR:1.22,CI:1.13–1.32), and rain-wetting (OR:1.27,CI:1.15–1.40); and RTIs with rain-wetting (OR:1.53,CI:1.34–1.74), and recent-travel (OR:1.17,CI:1.05–1.30). Conclusions The SWORD study showed wide seasonal variations in outpatient attendance of patients with common respiratory conditions. Novel risk-factors associated with respiratory diseases were also identified.

Pattern and trends of respiratory diseases in an outpatient setting: a five-year review in a tertiary hospital in South-South, Nigeria

“…10,19,24 Bronchial asthma was more common in females, which is consistent with previous research, indicating a potential role of reproductive hormones in the reversal of male predominance at puberty. 23,[26][27][28] Conversely, TB and COPD were more prevalent in males, consistent with previous reports in Nigeria. 10,18,19 There was a slight male preponderance observed in ILD and lung cancer, whereas Alasia et al found a female preponderance in ILD, which they attributed to the higher incidence of rheumatic disease in females.…”

“…COPD remains the leading cause of respiratory disease-related deaths, and it contributes significantly to frailty and geriatric medicine, as demonstrated by this study. 1,3,23,26 The differences in the age distribution of these respiratory diseases may be attributed to various factors, including environmental exposures, genetic predisposition, and comorbidities.…”

Tuberculosis epidemic in India – a systematic review

“…11,34,45 Similar to this, the Seasonal Waves of Respiratory Disorders study discovered strong correlations between seasonal variation and a high prevalence of TB, with symptoms worsening slightly in the summer and exacerbating in the autumn as a result of climatic variations in various parts of India. 46 Similarly, research has revealed that atmospheric temperature is an important factor and has a significant association with the progression of TB during the summer and monsoon seasons (Fig. 4).…”

“…6), which may be attributed to men's more intense outdoor activities and women's greater likelihood of accessing health services. 1,3,4,20,38,41,46,54,55 In fact, many PTB patients used dangerous sputum disposal techniques, which are dominant in male and illiterate patients from lower socioeconomic groups. 1,22,31,[41][42][43][44]56 Fig.…”

Re-examining the Nexus Between Maternal Smoking Behavior and Under-Five Children’s ARI in India: A Comprehensive Study

“…7 Like regional variation, household-level variation in the prevalence of ARIs among children under-five is also significant in LMICs. 8,9 In particular, household-level factors such as using cooking fuel, having a separate kitchen, ventilation, WASH (water, sanitation, and hand washing) practices, household wealth quintile, and tuberculosis among household members are significant predictors of ARIs. 10,11 Household wealth-based inequality in ARIs among under-five children is also noteworthy in highly focused ARI-prone regions like sub-Saharan African and South Asian countries.…”