G ARD
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Transcript of G ARD
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GGARD
Nan Shan ZhongNan Shan ZhongCChina
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The first ten leading causes of death in urban China (2003)
Rank Disease Mortality(per 105)1 Malignant tumor 134.52 Cerebrovascular diseases 105.43 Respiratory diseasesRespiratory diseases 77.377.34 Heart diseases 76.25 Trauma/Poisoning 32.66 Digestive diseases 19.37 Endocrinal, Nutritional &
Metabolic Disorders14.1
8 Genitourinary diseases 7.19 Neurological diseases 4.8
10 Perinatal diseases 162.1
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The first ten leading causes of death in rural China (2003)
Rank Disease Mortality (per 105)1 Malignant tumor 95.72 Cerebrovascular diseases 89.93 Respiratory diseasesRespiratory diseases 70.970.94 Heart diseases 45.55 Trauma/Poisoning 21.56 Endocrinal, Nutritional & Metabolic
Disorders14.5
7 Digestive diseases 10.58 Genitourinary diseases 7.29 Perinatal diseases 372.2
10 Pulmonary TB 4.2
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2,000 ~ 2,500
1,500 ~ 2,000100 ~ 500
1 ~ 100
11 ~ 50
BeijingBeijing
GuangdongGuangdong
ShanxiShanxi
Survey cities: 14 sites from 7 cities (Beijing, Shanghai, Tianjin, Shenyang, Xi’an, Chongqing, Guangzhou)
Shanghai
Tianjin
Chongqing
Shenyang
Xi’an
Beijing
Guangzhou
Ren PX et al 2005
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Overall prevalence of COPD in China
12. 1
4. 9
7. 8
12. 7
5. 4
8. 8
12. 4
5. 1
8. 2
02468
101214
Male Female Total
prev
alen
ce o
f CO
PD(%
)
Urban Rural Total
*
#
* Male VS Female: P<0.01; # Urban VS Rural: P<0.01
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COPD mortality rates per 100,000 population
0
10
20
30
40
50
60
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
Chi na(M) Chi na(F) HongKong(M) HongKong(F) Aus(M) Aus(F)
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Exacerbationsdays in last 6 months
None20%
Up to 512%06-10
18%
26+25%
11-1511%
16-2011%
21-253%
Base: 752 patients
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Number of Times Hospitalised for COPD
in the last year
0%
20%
40%
60%
80%
100%Five+ times
Four times
Three times
Twice
Once
None
Base: 752 patients
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0. 0
5. 0
10. 0
15. 0
20. 0
25. 0
0-15 15-30 30-45 45+ packs*years
preval ence % mal e femal e toatal
Association Between Prevalence of COPD And Smoke-index
# tests for trend : P<0.000
#
##
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Prevalence of Smoking in China
(Chinese Academy of Preventive Medicine 1996)
Population (15yrs) 130,657
Current smoker 35.3%
Male 63.0%
Female 3.8%
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Shaoguan
Guangzhou
Shaoguan rural (northern part of Guangdong province) and Guangzhou city (the capital city of Guangdong province) of China was selected to be studied. Total 3449 subjects investigated, response rate 81.3% .
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Comparison of COPD prevalence in smoker and non-smoker in Guangdong province
△ P<0.01, compared with Guangzhou; * P<0.01, compared with Non-smoke; ▲ P<0.05, compared with Non-smoke.; ** P<0.01, compared with Non-smoke; OR=2.723(2.145-3.456).
Guangzhou ShaoguanShaoguan Total
Male female total male female totalmale female total male female total
Non-smoker
smoker
10.7 2.7 4.9 13.8 7.213.8 7.2 △ △ 7.87.8△△ 11.3 4.9 6.16.1
16.4▲ 4.2 11.9* 18.9 0 18.818.9 0 18.8**△△ 17.9* 4.1 15.115.1****
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+:with biomass or cigarette exposure; – : without biomass or cigarette exposure ▼ compared with (4) p = 0.017, ▲ compared with (4) p = 0.000 , ** compared with (3) p= 0.003, * compared with (4) p= 0.000 ,◆ compared with (3) P= 0.000, ★ compared with (2) P= 0.001
Exposure factor ( biomass/ cigarette smoking ) Prevalence in corresponding
exposure factor (%)(1) Biomass(+)/cigarette smoking(+) 19.3*◆★
(2) Biomass(-)/cigarette smoking(+) 12.3▲**
(3) Biomass(+)/cigarette smoking(-) 7.7▼
(4) Biomass(-)/cigarette smoking(-) 5.1
Association between COPD prevalence and exposure to biomass and cigarette smoking
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0.00%
0.50%
1.00%
1.50%
2.00%
2.50%
1990 2000(432500 population in 31 cities)
National Cooperative Group of Children Asthma
Current Asthma Prevalence of Children (0-
14yrs) in China
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1GINA Treatment GuidelineNo (or minimal) need foremergency hospital visit/hospitalization
China Survey Findings 33% had visited the emergency room at hospital in the past year 16% of these patients had been hospitalized during the previous year
30%
19%
15%
26%
33%
16%
0% 10% 20% 30%
UnscheduledEmergency Visits
Hospital EmergencyRoom
Hospitalized in PastYear
Chi naAIRIAP Total
Summary of Hospital and Emergency Visits for Asthma in Past Year
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Have Lost Work/School Days in the Past Year Due to Asthma
20%
25%
0%
5%
10%
15%
20%
25%
30%
35%
40%
China
Adults Children
GINA Treatment GuidelinesNo missed school or work
China Survey FindingsUp to 25%(20%) missed work (school) because of asthma inthe past year
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CRD in China
Current patientsCOPD 32.8 millionsAsthma 39.0 millionsDeaths 1.6 millions
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Chronic Respiratory Diseases (CRD) Are a Major
Burden in China
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Distribution of economic status areas depending on the global country income
LuxembourgLuxembourg($69056/($69056/1)1)
U.S.U.S.($42076/7)($42076/7)
Japan Japan ($36486/10)($36486/10)
KoreaKorea($14649/($14649/34)34)
BrazilBrazil($3311/77)($3311/77)
TurkeyTurkey($4437/66)($4437/66)
ThailandThailand($2807/84)($2807/84)
ChinaChina($1352/112)($1352/112)
BurundiBurundi($123/179)($123/179)
BurmaBurma($135/176)($135/176)
RussiaRussia($4750/63)($4750/63)
IndiaIndia($652/133)($652/133)
The International Monetary Fund, IMF(2005)
Country(GDP per capita/rank)