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Deaths Due To Respiratory Diseases In India

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Last Updated: 02 July 2021

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General | Latest Info

India has 18% of the world population but 32% of the Global Burden Of Respiratory Diseases. The Respiratory Disease Burden in India is second only to that of ischaemic heart Disease, find State-level analysis of Global Burden Of Disease data. Chronic Respiratory Diseases were responsible for 10. 9% of total deaths and 6. 4% of total DALYs in India in 2016. Corresponding figures for 1990 were 9. 6% and 4. 5%, respectively. READ | Prevalence of diabetes up by 150% in 26 Years, find Lancet Global Health Study Pollution was the biggest contributor to the Respiratory Disease Burden. About 33. 6% Of COPD could be attributed to Ambient Air Pollution, 25. 8% to household air pollution and 21% to smoking. The National Health Policy Of India 2017 recommends that premature mortality from non-communicable diseases, including Chronic Respiratory Diseases, should be reduced by 25% by 2025. Cardiovascular Diseases, on the other hand, contribute to 28. 1% of total deaths and 14. 1% of total DALYs in India in 2016, compared with 15. 2% and 6. 9%, respectively, in 1990. The prevalence of ischaemic heart disease in 2016 was highest in Kerala, followed by Punjab, Tamil Nadu and Maharashtra. Deaths due to cardiovascular diseases in India increased from 1. 3 million in 1990 To 2. 8 million in 2016. Both papers on Respiratory Diseases and cardiovascular Diseases were published in Lancet Global Health. Professor Balram Bhargava, secretary, department of Health Research and DG ICMR, say: These papers through detailed analysis have elucidate disease and risk factor trends of major NCDs and suicide in every State for over 26 years. While it is known that NCDs have been increasing in India, major finding of concern is that the highest rate of increase in ischaemic heart disease and diabetes is in less developed states of India. These states already have a high burden from Chronic Obstructive Lung Disease and a range of infectious and childhood diseases, so control of NCDs in these states has to be boosted without delay. Dr Sundeep Salvi, director of Pune-base Chest Research Foundation, WHO chairs the Chronic Respiratory Diseases section of the paper, told Indian Express that India needs a National Chronic Respiratory Disease Control programme to tackle this growing problem. People will need to be made aware about burden and risk factors associated with CRDs. We need to create a focus on CRDs as part of the Ayushman Bharat Initiative, Dr Salvi say, adding that there was a need to develop community screening programmes, enhance infrastructure and skills at primary and secondary healthcare levels to enhance early and accurate diagnosis and proper treatment, and ensure that drugs for Asthma and COPD are make available at all public hospitals in India. The study is a joint initiative of the Indian Council Of Medical Research, public Health Foundation Of India, and the Institute For Health Metrics and Evaluation in collaboration With Ministry Of Health, along with experts and stakeholders associated with over 100 Indian institutions. For all the latest Indian News, download Indian Express App.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Background

Generally, age above 40 years is considered as the COPD target age group. This is primarily based on the assumption that tobacco smoking, which is the primary risk factor for COPD, begins in adolescence, and it would take 20-25 years of exposure to tobacco smoke to induce characteristic pathophysiologic changes of COPD in human lungs. However, in India, domestic exposure to indoor-air pollution resulting from burning solid biomass, other health-adverse fuels and mosquito coil use has emerged as another important risk factor for COPD. As exposure to indoor-air pollution may begin from infancy or childhood in homes where biomass fuel is traditional fuel for cooking, young adults in Indian subcontinent are likely to develop COPD at an early age. In humans, lung function keeps improving until early adulthood and subsequently undergoes natural physiological decline. 21 Therefore, we wish to estimate the prevalence of COPD in a population between 25 and 40 years of age and identify associated risk factors. Following conditions that could either affect safety of study participants during Spirometry testing or influence outcome of Spirometry are considered as exclusion criteria: Any surgery on the abdomen, chest or eye in the last 3 months. Women in the last trimester of pregnancy. Myocardial infarction in the last 3 months. Hospitalisation due to any heart problem within the past month. Currently on treatment for TB. Resting pulse more than 120 per minute. Respiratory infections including common cold in the last 3 weeks. Use of bronchodilators in last 6 hours. COPD: Any one of the following two standard spirometry definitions: Post-bronchodilator force expiratory volume in 1 s / force vital capacity < 70%. 1 Post-bronchodilator FEV 1 / FVC < lower limit of normal. 22 23 GOLD Committee published a consensus statement in 2001 for use of fixed FEV 1 / FVC < 70% value and fixed FEV 1 values to classify severity of COPD. 24 Lately, it has been realised that the prevalence of Spirometry-base COPD is higher when using fix values of FEV 1 / FVC in comparison to using LLN. 25 longitudinal study reported that the in-between group appear to have a higher risk of hospitalisation and mortality attributable to some Lung pathology. Therefore, it is believed that using LLN of FEV 1 / FVC underestimates COPD. 26 in absence of clear evidence in India in favour of either of two above-mentioned definitions, we decide to diagnose COPD based on both definitions. This will enable the US to determine which criterion is better and more clinically relevant for COPD diagnosis in Indian setting. B. Asthma: diagnosis of Asthma will be done using the Global Initiative for Asthma 27 guidelines: history of variable respiratory symptoms confirm variable expiratory airflow limitation with pre-and Post-bronchodilator Spirometry. Positive bronchodilator reversibility test; increase in FEV 1 of > 12% and 200 mL from baseline, 10-15 min after 400 g of salbutamol or equivalent. C. Post-TB sequelae: Information on the past history of pulmonary TB will be collected using a validated questionnaire.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Introduction

Lower Respiratory tract infections such as Pneumococcal pneumonia, Haemophilus influenzae type b, Respiratory syncytial virus and Influenza are leading causes of morbidity and mortality, particularly in children younger than five years. In India, about 82 448 children die of Pneumococcal pneumonia, 20 987 deaths were attributed to Haemophilus influenzae type b, 8 415 died due to Respiratory syncytial virus and 2 352 succumb to Influenza in 2015, followed by Nigeria and Pakistan. Hib was the major cause of under-5 LRI mortality in India, responsible for 14. 9% of LRI deaths, study say. In parallel, LRIs cause 2. 74 million deaths across the world in 2015, including all studied countries. A Study by Ali H. Mokdad, Institute For Health Metrics and Evaluation, University of Washington, Seattle, US, estimates Diseases Burden in 195 countries with Global Burden of Disease Study 2015. Study find that the burden of LRIs is highest in areas of low Socio-demographic status, populations that depend on solid fuels for cooking and heating, and in malnourish and immune-impaired populations. A study has revealed that under-5 LRI mortality was nearly the same in males and females at the global level, but in India it was 1. 22 times higher in girls than in boys in India. In India, there is a preference for male children and female newborns are not given preference for treatment and hospitalisation when they are sick. We introduce vaccines but reach and acceptance of vaccinations remain a problem. Over 150 000 children die due to pneumonia in India and over 40 000 to 60 000 due to vaccination preventable deaths. Children in rural areas remain malnourished and catch diseases faster. We are doing our best to prevent these deaths, said Ajay Khera, public health specialist and deputy commissioner In-charge, at the ministry of Health and family welfare. Researchers have called for vaccination and improving nutrition in affected countries. Expand use of Pneumococcal conjugate vaccine, interventions to improve under-5 nutrition, and focus on appropriate case management could reduce the burden of LRI. Comprehensive and reliable data on LRI morbidity and mortality globally is still needed study say. LRI remain largely preventable disease and cause of death, and continued efforts to decrease indoor and ambient air pollution, improve childhood nutrition, and scale up use of Pneumococcal conjugate vaccine in children and adults will be essential in reducing the global burden of LRI, it say. JP Nadda, Union minister For Health and family welfare, in May this year introduced the Pneumococcal conjugate vaccine in the Universal Immunization Programme. Pneumonia kills more children under five years of age in India than any other infectious disease. The Pentavalent vaccine, which was scaled up in all States under UIP by 2015, protects against Haemophilus influenzae type b pneumonia. Now, introduction of PCV in UIP will reduce child deaths from Pneumococcal pneumonia.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Method

There are many unanswered questions about the epidemiology of COPD in India and there is a paucity of systematically collected prevalence data using well-standardise protocols from India. Most of available prevalence estimates are not based on spirometry testing or adopt non-standard methods. 18 32-48 However, Spirometry is internationally accepted gold standard for diagnosis of COPD. 1 Hence, available data cannot be interpreted in a global context. A recent study on COPD prevalence from three cities in India using standardised methodology does not have adequate sample size to reflect the true Burden of Disease. 19 Further, same study does not represent Southern and Eastern parts of India. Also, no study in India has concurrently estimated other CRD such as asthma and post-TB sequelae, which are important comorbidities of COPD and are reported to have significant impact on clinical presentation and prognosis of disease. The current study will generate reliable prevalence estimates and describe risk factors in community using standardise methods. The same study will also estimate COPD prevalence and describe risk factors among younger adults. In this age group, information on COPD Burden is not readily available. On successful completion of the project, we will be able to decide whether more centres will be required to obtain more dependable, uniform and geographically more representative data that could provide a clear and holistic picture of the prevalence of COPD across the country. Knowledge of the prevalence of COPD from multiple sites would also help in modelling studies for COPD Disease Burden estimation at National and sub-National levels. Further, prevalence study sites will act as future focal points for initiating long-term cohort studies to define phenotypes and genotypes of obstructive Lung Diseases in India.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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