1. COPD Local Burden The Philippines

2. COPD A Global Health Concern COPD a growing cause of morbidity & mortality worldwide 5 th leading cause of death (2002)  4 th in 2030 (WHO) -Ageing of the world’s population -Continued use of tobacco -Air pollution COPD A Global Health Concern Lopez AD. Lancet 2006; 367:1747-1757 WHO. World Health Report 2002 Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2009

3. COPD: Prevalence (Phil.)  Previously reported estimates:  3.7% (Yu CY, Chavez JC, Blanco JB et al. Prevalence of Chronic Obstructive Pulmonary Disease in a Rural Philippine Community Barangay Banca-Banca, Victoria, Laguna. Phil J of Chest Diseases 1987; 137-151.)  2.3% (Roa CC, Dantes RB, Francisco NA et al. A Prevalence Survey of General Pulmonary Symptoms and Acute and Chronic Lung Diseases in an Urban Philippine Community. Phil J Internal Medicine, 1991: 29: 309-321. )  Previously reported extrapolated values:  6.3 % (Dans A, Fernandez L, Fajutrao et al. The Economic Impact of Smoking in the Philippines. Phil J of Internal Medicine, 1999: 37: 261-268.)

4. Population Prevalence of GOLD Stage I and Stage II & Doctor Diagnosed COPD in Manila, Philippines Sources:Buist AS et al. International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study. Lancet 2007 Dantes R et al. COPD prevalence in Manila, Philippines: results from the Burden of Obstructive Lung Disease (BOLD) study.(Unpublished) COPD is Underdiagnosed

5. Local Burden and Prevalence of COPD COPD is one of the top ten leading causes of mortality in the Philippines 1 Philippines (Manila): 3 rd highest prevalence of COPD stage II or higher in BOLD study 2 1 WHO Philippines Environmental Health Country Profile March 2005. 2 Buist AS et al. International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study. Lancet 2007 3 Idolor LF, de Guia TS, et al. Respirology.Oct 2011; 16 (7):1111-8. 4 Dantes R et al. COPD prevalence in Manila, Philippines: results from the Burden of Obstructive Lung Disease (BOLD) study.(Unpublished) CPG in the Diagnosis and Management of COPD in the Philippines 3 rd Update 2008 version. COPD Prevalence in the Philippines GOLD Stage I or higher GOLD Stage II or higher Urban (Manila) 2 13.9%12.5% Rural (Nueva Ecija) 3 20.8%16.7% Men (19.6 %) > Women (8.6%) 4 Prevalence increased with age 4 Increased with increasing pack years in men 4

6. Buist AS et al. International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study. Lancet 2007

8. Risk Factors for COPD Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. GOLD 2011 http://legacy.owensboro.kctcs.edu/gcaplan/anat2/notes/Image189.gif Tobacco Smoke Occupational dust and chemicals Indoor and Outdoor Air pollution Genes Age/Gender Socioeconomic Status Lung growth and development Infection, Asthma, Chronic Bronchitis

9. Idolor LF, de Guia, et al. Respirology. Oct 2011; 16 (7):1111-8. http://legacy.owensboro.kctcs.edu/gcaplan/anat2/notes/Image189.gif Tobacco Smoke Use of firewood for cooking Working on a farm Risk Factors for COPD 1 History of TB