Prevalence of COPD in five Colombian cities situated at low, medium, and high altitude (PREPOCOL study).

BACKGROUND: The prevalence of COPD in Colombia is unknown. This study aimed to investigate COPD prevalence in five Colombian cities and measure the association between COPD and altitude. METHODS: A cross-sectional design and a random, multistage, cluster-sampling strategy were used to provide representative samples of adults aged >or= 40 years. Each participant was interviewed (validated Spanish version of the Ferris Respiratory Questionnaire) and performed spirometry before and after 200 microg of inhaled salbutamol, using a portable spirometer according to American Thoracic Society recommendations. COPD definitions were as follows: (1) spirometric: fixed ratio (primary definition): FEV1/FVC < 70% after bronchodilator; (2) medical: a diagnosis of chronic bronchitis, emphysema, or COPD made by a physician; (3) clinical: cough and phlegm >or= 3 months every year during >or= 2 consecutive years (chronic bronchitis). Analysis was performed using statistical software. RESULTS: A total of 5,539 orsubjects were included. The overall COPD prevalence using the primary definition (spirometric) was 8.9%, ranging from 6.2% in Barranquilla to 13.5% in Medellín. The prevalence measured by the spirometric definition was higher than medical (2.8%) and clinical (3.2%) definitions. After the logistic regression analysis, the factors related with COPD were age >or= 60 years, male gender, history of tuberculosis, smoking, wood smoke exposure >or= 10 years, and very low education level. There was a nonsignificant tendency toward larger prevalence with higher altitude. CONCLUSION: COPD is an important health burden in Colombia. Additional studies are needed to establish the real influence of altitude on COPD prevalence.

Asthma and other allergic conditions in Colombia: a study in 6 cities.

BACKGROUND: No detailed information is available on the burden and impact of allergic diseases simultaneously for adults and children in Colombia and most Latin American countries. OBJECTIVES: To investigate the prevalence of asthma, allergic rhinitis, and atopic dermatitis symptoms in 6 cities in Colombia; to measure patient expenses and school days and workdays lost; to describe disease severity; and to determine levels of total and specific IgE in asthmatic subjects. METHODS: A multistage stratified random sample selection of schools with subjects aged 5 to 18 years in each city was used. Guardian subjects selected were contacted, and home visits were arranged. Subjects aged 1 to 4 years and older than 19 years were also selected randomly by systematic sampling based on the addresses of the subjects aged 5 to 18 years. Subjects with asthma symptoms were invited to provide a blood sample. RESULTS: Information was obtained from 6,507 subjects. The prevalence of asthma, rhinitis, and atopic dermatitis symptoms in the past 12 months was 10.4% (95% confidence interval [CI], 9.7%-11.1%), 22.6% (95% CI, 21.6%-23.6%), and 3.9% (95% CI, 3.4%-4.4%), respectively. Thirty-eight percent of asthmatic subjects had visited the emergency department or have been hospitalized, and 50% reported lost school days and workdays. Seventy-six percent of sampled asthmatic patients were considered to be atopic. CONCLUSIONS: The burden of disease and societal consequences of allergic entities in urban settings in countries such as Colombia are of concern but are largely ignored, perhaps because of the misconception that these diseases are of public health importance only in industrialized nations.

Sindrome del edificio enfermo (SEE): Prevalencia de sintomas alergicos, respiratorios y neurologicos asociados al ambiente cerrado de un edificio de oficina / Ill building syndrome

Objetivo: Determinar la prevalencia de síntomas alérgicos, respiratorios y neurológicos en trabajadores de un edificio de oficinas; asociar la prevalencia de los diferentes síntomas en función de la edad, el sexo, localización, frecuencia de presentación en la semana, antecedentes personales de rinitis, asma, alergias y ausentismo laboral, para compararlos con estudios realizados en otros países. Material y métodos: El estudio se realizó en Medellín; se seleccionó de forma aleatoria una muestra representativa de trabajadores, según la densidad de población en cada piso, expuestos a aire acondicionado central, en un edificio de trece pisos y un sótano, con una población total de 1.920 trabajadores. Se calculó la muestra teniendo en cuenta un nivel de confianza del 95 por ciento y un margen de error máximo del 5 por ciento. Se tuvo en cuenta la prevalencia de estos síntomas, en diferentes series de la literatura; previamente estandarizado con prueba piloto se aplicó el cuestionario entre octubre de 1996 y julio de 1997, por médicos y enfermeras adiestrados para tal fin. Resultados; Se aplicó el cuestionario a 350 trabajadores, 88(25.1 por ciento) hombres y 262 (74.9 por ciento) mujeres, la mayoría de ellos, 268 (76.6 por ciento), entre 30 y 49 años, presentaron algún síntoma 323 (92.3 por ciento); síntomas alérgicos como carraspera, estornudos, prurito nasal, la mayoría de ellos (62.6 por ciento, 57.1 por ciento, 50.0 por ciento respectivamente); síntomas neurológicos tales como cefalea y mareo, 189 (54.0 por ciento); síntomas respiratorios tales como tos, 131 (37.4 por ciento) y respiración corta 95 (27.1 por ciento). Los síntomas se presentaron principalmente el primer día de la semana, 323 (92.3 por ciento); se asociaron con antecedentes personales de rinitis, asma y alergias 111 personas (31.8 por ciento). 118 (33.7 por ciento) eran fumadores activos; 297 (84.9 por ciento) dijeron haber tenido al menos un episodio gripal en el último año y 97 (27.7 por ciento) fueron incapacitados por este problema...