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      Highlights of an Expert Advisory Board on Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AE-COPD) in Latin America

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          Abstract

          Background

          Chronic obstructive pulmonary disease (COPD) is a preventable and usually progressive lung disease that affects millions of people worldwide and is the sixth leading cause of death in the Americas. Viral and bacterial respiratory tract infections and air pollution may cause acute exacerbations of COPD (AE-COPD) ranging from mild, moderate to severe. The greatest proportion of the overall COPD burden on the health system is due to disease exacerbations. There is limited evidence regarding the etiology and burden of AE-COPD in Latin America (LATAM).

          Methods

          To respond to this gap in evidence, an Advisory Board with regional pneumologists and infectious disease experts was convened in September 2018 in Panama City, Panama, to: 1) review the burden of AE-COPD in LATAM; 2) evaluate the etiology of AE-COPD in LATAM; and 3) assess and compare the local/regional guidelines to confirm the etiology, characterize, and manage AE-COPD.

          Results

          The results of the meeting showed that there is a high prevalence of AE-COPD in LATAM countries, limited evidence on etiology data, and discrepancies in the case definitions and symptomology (ie, severity) classifications used in LATAM.

          Conclusion

          The Advisory Board discussions further resulted in recommendations for future research on the impact on the epidemiology and burden of disease, on establishing standardized AE-COPD case definition guidelines, and on studying the etiology of both moderate and severe AE-COPD cases.

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          Most cited references 23

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

          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. 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 or= 3 months every year during >or= 2 consecutive years (chronic bronchitis). Analysis was performed using statistical software. 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. COPD is an important health burden in Colombia. Additional studies are needed to establish the real influence of altitude on COPD prevalence.
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            Determinants of underdiagnosis of COPD in national and international surveys.

            COPD ranks within the top three causes of mortality in the global burden of disease, yet it remains largely underdiagnosed. We assessed the underdiagnosis of COPD and its determinants in national and international surveys of general populations.
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              Exacerbations of COPD

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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                copd
                copd
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove
                1176-9106
                1178-2005
                06 August 2020
                2020
                : 15
                : 1919-1929
                Affiliations
                [1 ]GSK , Panama City, Panama
                [2 ]Fundación Neumológica Colombiana , Bogota, Colombia
                [3 ]Director of Pneumology Specialization Course, University of Buenos Aires , Buenos Aires, Argentina
                [4 ]FUNCEI-Bernardo Houssay Hospital , Buenos Aires, Argentina
                [5 ]Pulmonary and Critical Care Medicine, CEMIC , Buenos Aires, Argentina
                [6 ]Pulmonary Rehabilitation Unit, Federal University of São Paulo (UNIFESP) , São Paulo, Brazil
                [7 ]MSc Head of COPD Clinic at National Institute of Respiratory Diseases , Mexico City, Mexico
                [8 ]Pulmonary and Critical Care Division, National Institute of Nutrition Salvador Zubiran , Mexico City, Mexico
                [9 ]Education and Investigation Coordination Unit, San Miguel Arcangel Hospital, Ministry of Health , Panama City, Panama
                Author notes
                Correspondence: Adriana Guzman-Holst; Patricia Juliao GSK , Ciudad Del Saber, Building 230, Panama City, PanamaTel +507 2632204 Email adriana.x.guzman@gsk.com; patricia.d.juliao@gsk.com
                Article
                261258
                10.2147/COPD.S261258
                7418149
                © 2020 Naranjo et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 1, Tables: 5, References: 35, Pages: 11
                Funding
                Funded by: GlaxoSmithKline Biologicals S.A;
                GlaxoSmithKline Biologicals S.A. funded this study and all costs related to the development of related publications.
                Categories
                Original Research

                Respiratory medicine

                consensus, copd, exacerbations, diagnosis, epidemiology, etiology

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