Global Burden of COPD: Prevalence, Patterns, and Trends

Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory condition characterized by small airway and parenchymal lung disease resulting in expiratory airflow obstruction. While COPD has been well studied in highincome country (HIC) settings, epidemiologic and clinical studies focused on low- and middle-income country (LMIC) settings have been completed only more recently, where the majority of morbidity and mortality occurs. In addition to well-established risk factors in HIC (tobacco smoke exposure and genetic predisposition), populations in LMICs are exposed to additional risk factors which predispose individuals to develop COPD across the lifespan, including biomass exposure and nutritional deficiencies. Additionally, LMICs face challenges in the diagnosis and treatment of COPD including limited availability of equipment and access to therapies. In this chapter, we review the definition and diagnosis of COPD, the natural history, and risk factors and consider approaches to COPD management in LMICs.We additionally highlight areas of future COPD research relevant to LMICs.