Chronic Lower Respiratory Tract Diseases

Excerpt

Chronic respiratory diseases are common and increasing in relative terms as causes of disability and death. They refer to noninfectious conditions of the lung and respiratory tract, excluding cancers and trauma. In the International Classification of Diseases, they are covered mostly in chapter X (table 15.1) (WHO 2010). This chapter focuses on the more common of these conditions, but we have been influenced by the availability of data. Not addressed are two common conditions of the upper respiratory tract—allergic and chronic rhinosinusitis—that cause considerable disability but are not associated with substantial mortality. Smoking cessation and reduction or elimination of other harmful exposures is an important component of the management of any chronic respiratory disease. Tobacco cessation is addressed in chapter 4 in this volume (Roy and others 2017) and in chapter 10 of volume 3 (Jha and others 2015).

The two main conditions contributing to death and disability are asthma and chronic obstructive pulmonary disease (COPD). Both are clinical diagnoses and are associated with narrowed airways and difficulty exhaling. Asthma has become more common in many countries in parallel with increasing prevalence of allergic sensitization. COPD, in particular, is an increasing burden as the world’s population ages and tobacco smoking increases in many low- and middle-income countries (LMICs), especially among women. The effects of both diseases and mortality from all causes tend to be greater in persons with smaller lungs, and smaller lung volumes are more common in LMICs.

Although these diseases are rarely curable, effective treatments to reduce both disability and death are available and affordable.