Burden of chronic respiratory diseases in population in four South/South-East Asian low-and middle-income countries (LMICs).

Background: Prevalence surveys rarely report the day-to-day burden of chronic respiratory diseases (CRDs). We aimed to assess the burden of CRDs on quality of life, work/activities, and use of healthcare resources in Bangladesh, India, Malaysia, and Pakistan. Methods: Using random sampling, in five sites in the four LMICs, we piloted a questionnaire (BOLD-1 + eight questions from ECRHS-II). Prevalence data has been published (Agarwal J Global Health 2021; 11:04065). We here report a descriptive analysis of CRDs burden. Results: Of 508 participants, 496 provided complete data of whom 273 (55.0%) reported one or more chronic respiratory symptoms (e.g., breathlessness 28.8%; wheezing 21.4%). Prevalence of CRDs in our study population was estimated as 24.4% (asthma [16.7%], COPD [4.6%], other CRDs [3.1%]). Impact on lifestyle amongst those with CRDs was substantial: 42.9% [CI 34.0-52.2%] reported interference in social activities; 62.8% [CI 53.5-71.4%] reported that their physical health limited their daily activities; 17.4% [CI 11.0-25.3%] reported that their health problem stopped them working for income. 52.9% [CI 43.6-62.0%] felt depressed which further affected their quality of life and capacity to work. Only 36.3% [CI 27.8-45.6%] used government facilities for their healthcare; 79.2% [CI 70.8-80.6%] paid healthcare costs from their pocket. Conclusion: Only reporting prevalence fails to emphasise the substantial impact of CRDs on ability to work and restriction on social activities. Highlighting this burden adds weight to the need to develop sustainable interventions to improve quality of life of people suffering from CRDs in LMICs.