Prevalence, Risk Factors, and Outcomes of Chronic Bronchitis in LMICs: A Multi-Country Cohort St

19 Mar 20264 min read0 viewsJournal Feed

GIST

Chronic bronchitis affected 9.7% of adults ≥40 years across three LMIC populations (Bhaktapur, Lima, Nakaseke) in this population-based cohort (mean age 56.2 years; 49.0% male; 33.1% ever-smokers). Among those with chronic bronchitis, 31.5% also had COPD. A multivariable log-binomial model identified several factors independently associated with chronic bronchitis: older age (per 19.8-year increment; aRR 1.54, 95% CI 1.40–1.70), male sex (aRR 1.18, 95% CI 1.05–1.34), prior tuberculosis (aRR 1.45, 95% CI 1.14–1.83), prior asthma diagnosis (aRR 2.11, 95% CI 1.84–2.42), cumulative tobacco exposure (per 10 pack-years; aRR 1.16, 95% CI 1.14–1.18), family history of chronic respiratory disease (aRR 1.69, 95% CI 1.50–1.91), second-hand smoke exposure (aRR 1.45, 95% CI 1.28–1.64), lower socioeconomic status (aRR 1.22, 95% CI 1.07–1.39) and indoor biomass exposure (aRR 1.45, 95% CI 1.13–1.86).

Clinical Editorial

Summary

Prevalence and Determinants of Chronic Bronchitis in LMIC Populations: A Three-Country Cohort

Scope and design

Population-based cross-sectional assessment of adults aged 40 years and older across three low- and middle-income country sites: Bhaktapur, Nepal; Lima, Peru; and Nakaseke, Uganda.
Chronic bronchitis defined by a productive cough on several days per week during the past four weeks.
Analytical approach employed multivariable log-binomial regression to identify factors linked with chronic bronchitis and associated outcomes.

Key epidemiologic signal

Among 9,664 participants (mean age 56.2 years; 49.0% male; 33.1% ever-smokers), the overall prevalence of chronic bronchitis was 9.7%.
About one-third of individuals with chronic bronchitis also met criteria for COPD.

Notable risk factors and exposure profile

Age: each substantial increase in age carried higher risk (adjusted relative risk 1.54 per 19.8-year interval).
Sex: male sex associated with increased risk (aRR 1.18).
Personal respiratory history: prior tuberculosis and prior asthma diagnosis showed positive associations (aRRs 1.45 and 2.11, respectively).
Tobacco exposure: greater pack-years correlated with higher risk (aRR 1.16 per 10 pack-years).
Familial and environmental factors: family history of chronic respiratory disease, second-hand smoke exposure, lower socioeconomic status, and indoor biomass exposure all showed positive associations with chronic bronchitis.
Notably, second-hand smoke and biomass-related exposures demonstrated consistent, statistically supported links to chronic bronchitis within this LMIC cohort.

Clinical and functional context

Individuals with chronic bronchitis reported increased breathlessness and poorer respiratory health status, as reflected by higher St George's Respiratory Questionnaire scores.
Higher rates of hospitalization were observed among those with chronic bronchitis, indicating a greater burden on health services.

Contextual interpretation and limitations

No causal inferences are claimed beyond associations observed.

The study emphasizes chronic bronchitis as a relatively common condition within LMIC settings, with multiple modifiable risk factors identified, including environmental exposures and prior respiratory diseases.
The primary content presented supports associations but does not provide numerical outcomes beyond reported risk estimates and descriptive results.