Revista NCT

Prevalence and characteristics of chronic obstructive pulmonary disease in Panama Republic

Noriega-Aguirre, Lorena Itzel¹; Méndez, Joel²; Trujillo, Amny¹

2021, Number 3

2021; 80 (3)

ABSTRACT

Objective: To determine the prevalence and characteristics of chronic obstructive pulmonary disease (COPD), in the Panama Republic. Material and methods: A prevalence study was carried out in the Republic of Panama, in subjects over 40 years of age, who answered affirmatively to the survey of respiratory symptoms, and in whom the diagnosis of COPD was confirmed, after a clinical evaluation and spirometry study. Results: 877 surveys were applied to people over 40 years of age in the 10 provinces of the Republic of Panama. 39 participants presented COPD symptoms and spirometry, corresponding to a global prevalence for Panama of 4.4% CI (3.1-5.8). 56.4% CI (40.8-72.0) were male. 82.1% CI (70.1-94.1) had no previous diagnosis of COPD and 20.5% CI (7.83-33.2) had previously performed spirometry. The 43.6% CI (28.0-59.1) had positive smoking and 30.7% CI (16.2-45.2) had a history of exposure to biomass. The 46.1% CI (30.4-61.7) was classified in GOLD group B, 28% CI (13.9-42.0) in group D, 20.5% CI (7.8-33.1) in group A and 5.1% in group C, CI (3.5-6.7). The most frequent comorbidities, rhinitis 38.4% CI 95 (23.2-53.7), arterial hypertension 35.9% CI (20.8-51.0) and symptoms of gastroesophageal reflux 23.1% CI (9.9-36.3). The long-acting anticholinergics were most frequent drugs used. Conclusions: The prevalence of COPD in Panama is low; it occurs mainly in males, smoking and exposure to biomass are the most frequent exposures. Spirometry for its diagnosis is underused. The most frequent comorbidities were rhinitis, arterial hypertension and gastroesophageal reflux. Two thirds of COPD correspond to GOLD groups B and D, which are the most symptomatic, and the treatment they receive most frequently is based on long-acting anticholinergic bronchodilators.

KEYWORDS

Chronic obstructive pulmonary disease, biomass, smoking prevalence, Panama.

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2021, Number 3

2021; 80 (3)

Figure 1

Table 1

Table 2

Table 3

Table 4

Tabla 1: Características de pacientes con EPOC en la República de Panamá.
Característica		n	%	IC (95%)
Sexo	Masculino Femenino	22 17	56.4 43.6	40.8−72.0 28.0−59.2
Historia previa de EPOC	Sí	7	17.9	5.9−30.0
Espirometría previa	Sí	8	20.5	7.8−33.2
Media de FEV1/FVC			63.4
FEV1 posbroncodilatador	Leve > 80% Moderada 80-50% Grave 49-30% Muy grave < 30%	1 23 13 2	2.6 59.0 33.3 5.1	-2.4−7.5 43.5−74.4 18.5−48.1 -1.8−12.1
Historia de tabaquismo	Sí	17	43.6	28.0−59.2
Exposición a biomasa	Sí	12	30.7	16.3−45.3
Drogas inhaladas	Sí	1	2.6	-2.4−7.5
Índice de disnea mMRC	0-1	15	38.4	23.2−53.7
Índice de disnea mMRC	≥ 2	24	61.6	46.3−76.8
Cuestionario CAT	> 10 < 10	27 12	69.2 30.8	54.7−83.7 16.3−45.3
Índice de masa corporal	> 21 < 21	32 7	82.1 17.9	70.0−94.1 5.9−30.0
Exacerbaciones en 12 meses	0 1 ≥ 2	14 12 13	35.9 30.8 33.3	20.8−51.0 16.3−45.3 18.5−48.1
Hospitalizaciones en 12 meses	> 1 < 1	2 37	5.1 33.9	-1.8−12.1
EPOC = enfermedad pulmonar obstructiva crónica; FEV1 = volumen espiratorio forzado en el 1 segundo; FVC = capacidad vital forzada; mMRC = escala del Medical Research Council modificada; CAT = COPD Assessment Test.

Tabla 2: Clasificación basada en GOLD.
Exacerbaciones (≥ 2)	C 2.5% (1)	D 30.8% (12)
Exacerbaciones (0-1)	A 28.2% (11)	B 38.5% (15)
CAT	< 10	≥ 10
mMRC	0-1	≥ 2
GOLD = Global Initiative for Chronic Obstructive Lung Disease; CAT = COPD Assessment Test; mMRC = escala del Medical Research Council modificada.

Tabla 3: Morbilidades de pacientes con EPOC en la República de Panamá.
Característica	n	%	IC (95%)
Síntomas de rinitis	15	38.4	23.2−53.7
Síntomas de reflujo	9	23.1	9.9−36.3
Hipertensión arterial	14	35.9	20.8−51.0
Cardiopatías	4	10.3	0.7−19.8
Diabetes	2	5.1	-1.8−12.1
Dislipidemia	2	5.1	-1.8−12.1
Cataratas	4	10.3	0.7−19.8
Prostatismo	5	12.8	2.3−23.3
Algún tipo de cáncer	3	7.7	-0.7−16.1
EPOC = enfermedad pulmonar obstructiva crónica.

Tabla 4: Uso de medicamentos en pacientes con EPOC tratados en la República de Panamá.
Grupo de medicamento	n	%	IC (95%)
Pacientes con tratamiento previo	26	100.0
Beta 2 agonistas Corta acción (SABA) Acción prolongada (LABA)	7 10	26.9 38.5	9.9-44.0 19.8-57.2
Anticolinérgicos Corta acción (SAMA) Acción prolongada (LAMA)	8 18	30.1 69.2	13.0-48.5 51.5-87.0
Combinados LABA/LAMA	5	19.2	4.1-34.4
Esteroides inhalados	9	34.1	16.3-52.9
Combinados LABA/esteroides	5	19.2	4.1-34.4
EPOC = enfermedad pulmonar obstructiva crónica.