Purpose: To investigate the prevalence and risk factors for chronic obstructive pulmonary disease (COPD) in a rural area in western China with severe air pollution.
Patients and Methods: 10% of local residents aged 40 years and above were included using a convenience sampling method. This was a cross-sectional study. A self-designed questionnaire was used to collect participants’ demographic data. The screening program was comprised of two steps: First, a portable electronic spirometer was used for COPD screening. Those participants with FEV₁/FVC ratio < 0.7 were then referred to a confirmatory pulmonary function (PF) test. COPD was confirmed according to the 2020 Global Initiative for Chronic Obstructive Lung Disease criteria.
Results: A total of 4577 participants aged 40 years old or above were included in the final analysis. Examination with a mobile spirometer identified 1159 individuals for confirmatory testing; after that, of the 1159 individuals, 889 were diagnosed with COPD by the confirmatory PF test. The prevalence of COPD among the target group was 19.4%. Older age, male sex (odds ratio [OR] = 1.537, 95% confidence interval [CI] 1.246– 1.894), smoking history (OR = 1.338, 95% CI 1.069– 1.675), family history of respiratory disease (OR = 1.625, 95% CI 1.350– 1.957), education level (OR = 0.735, 95% CI 0.617– 0.876), overweight (OR = 0.614, 95% CI 0.517– 0.730) and obesity (OR = 0.572, 95% CI 0.449– 0.721) were identified as independent factors associated with COPD. The screening program helped earlier detection of COPD in 719 participants.
Conclusion: COPD was highly prevalent in the rural area studied. Rural residents who were older, current or ever-smokers, male and those who had a lower education level were more vulnerable to developing COPD. The COPD screening program may be helpful for earlier disease detection in rural health-care settings.
Keywords: chronic obstructive pulmonary disease, prevalence, primary care, pulmonary function test, risk factors