Factors Associated with Chronic Obstructive Pulmonary Diseases in Nepal: Evidence from a Nationally Representative Population-Based Study

Figures & data

Figure 1 Flow diagram of the study.

Table 1 Socio-Demographic Characteristics of the Study Population (N=8945)

Characteristics	N	%
Age
20–39	3080	34.4
40–59	3824	42.8
60 years and above	2041	22.8
Sex
Male	3807	42.6
Female	5138	57.4
Ethnicity
Upper caste group	3049	34.1
Disadvantaged Janajati	1878	21.0
Relatively advantaged Janajati	1504	16.8
Disadvantaged non-Dalit Terai caste	1355	15.1
Dalit	905	10.1
Religious minorities	254	2.8
Education
Illiterate/No formal schooling	4876	54.5
Below secondary (<10 years)	2064	23.1
Secondary and above (≥10 years)	2005	22.4
Province
Province 1	1504	16.8
Province 2	1473	16.5
Bagmati Province	2211	24.7
Gandaki Province	921	10.3
Province 5	1559	17.4
Karnali Province	462	5.2
Sudurpaschim Province	815	9.1
Place of residence
Rural	4611	51.5
Urban	4334	48.5

Table 2 Classification of COPD Based on GOLD Criteria

Categories	Number	Percentage	95% CI
Normal	6973	77.2	75.5–78.8
Restrictive defects	970	11.2	9.8–12.8
GOLD I: Mild obstruction	330	3.9	3.4–4.6
GOLD II: Moderate obstruction	473	5.4	4.7–6.2
GOLD III: Severe obstruction	143	1.7	1.4–2.1
GOLD IV: Very severe obstruction	56	0.6	0.4–0.9

Table 3 Descriptive Characteristics of Participants with COPD (N=8945)

Characteristics	Total	COPD		95% CI
Socio-Demographic Characteristics	N	n	%
Age
20–39	3080	197	6.2	4.9–7.7
40–59	3824	386	10.5	9.1–12.1
60 years and above	2041	426	21.6	19.3–24.1
Sex
Male	3807	478	12.5	11.1–14.1
Female	5138	531	11.0	9.6–12.4
Ethnicity
Upper caste group	3049	335	11.6	9.9–13.5
Disadvantaged Janjati	1878	177	9.3	7.7–11.1
Relatively advantaged Janjati	1504	151	10.2	8.3–12.5
Disadvantaged non-Dalit Terai caste	1355	200	15.2	11.9–19.2
Dalit	905	114	13.4	10.4–17.2
Religious minorities	254	32	12.4	8.0–18.6
Education
Illiterate/No formal schooling	4876	722	15.7	14.1–17.6
Below secondary (<10 years)	2064	186	9.0	7.6–10.6
Secondary and above (≥10 years)	2005	101	5.2	4.2–6.5
Province
Province 1	1504	92	6.2	4.8–8.0
Province 2	1473	240	16.4	13.2–20.3
Bagmati Province	2211	253	11.7	9.7–14.1
Gandaki Province	921	56	6.0	4.0–8.9
Province 5	1559	145	9.5	7.5–11.8
Karnali Province	462	109	25.1	18.1–33.8
Sudurpaschim Province	815	114	14.3	11.8–17.3
Place of residence
Rural	4611	523	11.7	10.0–13.6
Urban	4334	486	11.7	10.1–13.4
Lifestyle characteristics
Smoking status
Smokers	2990	482	16.8	14.9–18.8
Non-smokers	5955	527	9.1	7.9–10.5
Packs per year
0–14	8210	847	10.7	9.5–11.9
15–24	280	58	22.1	16.9–28.2
25–49	234	52	21.3	15.7–28.2
50+	221	52	25.5	19.6–32.5
BMI
Underweight	1108	247	21.7	18.5–25.4
Normal	5619	600	11.3	10.0–12.7
Overweight	2218	162	7.7	6.4–9.3

Figure 2 Geographical distribution of COPD prevalence by sex and residence in Nepal. The map is created using GMAP procedure in SAS 9.4.

Table 4 Socio-Demographic and Lifestyle Factors Affecting Chronic Obstructive Pulmonary Diseases (COPD) in Nepal (n=8945)

Variables	N	COPD			p value
		n (%)	OR (95% CI)	AOR 95% CI
Sociodemographic characteristics
Age (ref: 20–39 years)
20–39	3080	197 (6.2)
40–59	3824	386 (10.5)	1.8 (1.4–2.3)	1.5 (1.2–1.9)	0.002
60 years and above	2041	426 (21.6)	4.2 (3.3–5.4)	3.1 (2.3–4.1)	0.000
Sex (ref: female)	5138	531 (11.0)
Male	3807	478 (12.5)	1.2 (1.1–1.4)	1.0 (0.8–1.2)	0.841
Ethnicity (ref: disadvantaged Janajati)	1878	177 (9.3)
Upper caste group	3049	335 (11.7)	1.3 (0.1–1.7)	1.3 (1.0–1.7)	0.047
Relatively advantaged Janajati	1504	151(10.2)	1.1 (0.8–1.5)	1.2 (0.9–1.6)	0.281
Disadvantaged non-Dalit Terai caste	1355	200 (15.2)	1.8 (1.2–2.5)	1.5 (1.0–2.6)	0.029
Dalit	905	114 (13.4)	1.5 (1.1–2.1)	1.2 (0.9–1.7)	0.196
Religious minorities	254	32 (12.4)	1.4 (0.8–2.3)	1.2 (0.7–2.1)	0.441
Education (ref: secondary and above)	2005	101 (5.2)
Illiterate/no formal schooling	4876	722 (15.7)	3.4 (2.7–4.4)	2.0 (1.5–2.7)	0.000
Below secondary (<10 years)	2064	186 (9.0)	1.8 (1.4–2.4)	1.5 (1.1–2.1)	0.005
Province (ref: Gandaki Province)	921	56 (6.0)
Province 1	1504	92 (6.2)	1.0 (0.6–1.7)	1.0 (0.6–1.8)	0.937
Province 2	1473	240 (16.4)	3.1 (1.9–5.1)	2.6 (1.5–4.5)	0.001
Bagmati Province	2211	253 (11.7)	2.1(1.2–3.3)	2.2 (1.4–3.7)	0.002
Province 5	1559	145 (9.5)	1.6 (1.0–2.7)	1.6 (0.9–2.7)	0.091
Karnali Province	462	109 (25.1)	5.3 (2.9–9.7)	4.8 (2.6–8.9)	0.000
Sudurpaschim Province	815	114 (14.3)	2.6 (1.6–4.2)	2.4 (1.4–3.9)	0.001
Lifestyle characteristics
Smoking status (ref: non-smokers)	5955	527 (9.1)
Smokers	2990	482 (16.8)	2.0 (1.7–2.4)	1.3 (1.1–1.7)	0.006
Packs per year (ref: 0–14)	8210	847 (10.7)
15–24	280	58 (22.1)	2.4 (1.7–3.3)	1.3 (0.9–1.9)	0.102
25–49	234	52 (21.3)	2.3 (1.6–3.3)	1.3 (0.9–1.9)	0.198
50+	221	52 (25.5)	2.9 (2.0–4.1)	1.7 (1.1–2.4)	0.009
BMI (ref: normal)	5619	600 (11.3)
Underweight	1108	247 (21.7)	2.2 (1.8–2.7)	1.7 (1.4–2.1)	0.000
Overweight	2218	162 (7.7)	0.7 (0.5–0.8)	0.7 (0.5–0.9)	0.002