GETTING SERIOUS WITH COPD

 

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the 21st century. The Global Burden of Disease Study by the World Health Organization projected that COPD will become the third leading cause of death worldwide by 2020.(1)

It is a disease made more deadly by the fact that we tend to overlook it and often dismiss it as something that isnt serious.

At the observance of World COPD Day last week, host Ria Tanjuatco-Trillo began the program asking the audience about the english translation of the word “Sayang”

While there was no direct translation for the word, everyone knew that it signified a sense of regret, remorse, a feeling of disappointment, or feeling sorry for what happened. The word SAYANG is often followed by another common Filipino expression that denotes regret– SANA.

“Those two words are usually associated with COPD. Does everyone know what COPD is? Its unfortunate that a lot of people still remain clueless about Chronic Obstructive Pulmonary Disease or COPD. Unfortunate because COPD has become one of the leading causes of death in the Philippines.The theme for this year is “It’s not too late.” A positive message that emphasizes the meaningful actions people can take to improve their respiratory health, at any stage before or after even COPD diagnosis. Para walang SANA, para walang SAYANG,” Trillo said.

Today, as we observe World COPD Day, we are gathered here to shed light on this often overlooked disease and raise awareness so that we can eventually lessen its prevalence.”

In the Philippines, it ranks as the 7th leading cause of death with a prevalence rate of 13.8% in Manila.(2,3) Despite the high incidence of COPD in the Philippines, only 2% of the cases are diagnosed by doctors in contrast to the overall prevalence. (4)The cause of this under-diagnosis and under-treatment is probably due to lack of public health awareness of COPD in our country.

COPD is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lungs. Cigarette smoking continues to be identified as the most commonly encountered risk factor, accounting for 80-90% of cases. (6,7) Other risk factors that should be taken into account include air pollution, exposure to certain dust, chemicals in the workplace, indoor air pollution from biomass cooking (i.e. firewood/charcoal), and heating in poorly ventilated dwellings. Only a few cases of COPD are caused by genetic condition.

A clinical diagnosis should be considered in any person 40 years old and above who has risk factors such as exposure to noxious particles or gases. A COPD patient may not feel anything at the start and develop cough and sputum production during the mid to late stage of the disease. Thus, high index of suspicion is needed for any person with risk factors. Spirometry is needed to make a confident diagnosis of COPD. It is one of the diagnostic tools that is often underutilized in the Philippines. A person with risk factors and symptoms should ask his/her doctor about spirometry testing.

Following the presentation by Dr Bernice Ong De la Cruz of Philppine College of Chest Physicians, actor-director Eric Quizon then shared their family’s emotional journey as they took care of dad Dolphy who suffered from COPD. The Comedy King had been diagnosed with COPD and Eric said it taught everyone of them lot of lessons.

The impact of COPD is not only confined to its ill effects on the individual’s health but may also result in an economic and social burden that is both extensive and increasing.(6,7) There is a direct relationship between the severity of COPD and the cost of care. In developing countries like the Philippines, COPD will certainly force two individuals to give up their work – the person afflicted with COPD and a family member who must now stay home to care for the sick individual. Given that people are often the most vital asset for developing nations, the indirect costs of COPD potentially pose a serious threat to their economies.

Appropriate pharmacologic and non-pharmacologic interventions are needed to reduce the symptoms, frequency and severity of exacerbations and improve health status and exercise tolerance. Smoking cessation is without doubt still the single most effective way of reducing the risk of developing COPD and delaying its progression.

It is important to remember that for COPD patients, early detection of the disease and appropriate interventions are vital. These can help slow down its advance and facilitate quality of life for the patient. To quote 2014 World COPD Day’s theme: IT’S NEVER TOO LATE….
REFERENCES:

1. Murray CJL, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet 1997; 349: 1498-1504.
2. National Objectives for Health 2011-2016 @ www.doh.gov.ph/national-objectives-health-2011-2016.html.
3. Buist A. et. al, International variation in the prevalence of COPD (The BOLD Study): a population based prevalence study. Lancet 2007; Vol 370, Issue 9589, 741-50.
4. Antes R., et. al, Philippine BOLD initiative manuscript. Unpublished.
5. US Surgeon General. The health consequences of smoking: Chronic Obstructive Lung Disease. US Department of Health and Human Research, 84-50205, 1984.
6. Lopez AD, Shibuya K, Rao C, et. al, Chronic obstructive pulmonary disease; current burden and future projections, EurResper J. 2006; 27: 397-412.
7. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006; 3.