Prevalence of ACO (Asthma COPD Overlap) and associated risk factors in Aboriginal people

Koleade, Adetola (2019) Prevalence of ACO (Asthma COPD Overlap) and associated risk factors in Aboriginal people. Masters thesis, Memorial University of Newfoundland.

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Abstract

Aboriginal peoples are at a higher risk of many chronic respiratory diseases compared to the general Canadian population. Gender differences in incidence, susceptibility and severity of chronic respiratory diseases have also been long recognized among Aboriginal Peoples. Patients with Asthma-COPD Overlap (ACO), a disease newly described in 2015, are associated with frequent exacerbations, rapid decline in lung function, poor quality of life, high mortality and disproportionate utilization of healthcare resources than patients with asthma and COPD alone. The aim of this analysis is to investigate the prevalence and risk factors of ACO in Aboriginal peoples and to assess their gender-specific risk factors. The Aboriginal Peoples Survey 2012 (N=28,410) is the fourth cycle of a national cross-sectional survey representative of the First Nations living off reserve, Metis and Inuit. The ACO definition was based on the respondent giving positive responses to both of the following questions “Do you/Does(name) have Asthma diagnosed by a health professional?” and “Do you/Does (name) have chronic bronchitis, emphysema or chronic pulmonary obstructive disease or COPD diagnosed by a health professional?” The prevalence of ACO was 1.65% and 3.53% in Aboriginal males and females respectively. Aboriginal peoples older than 45 years, having a total personal income below $20,000 were associated with a significant risk of ACO. Residing in Ontario and Quebec, living in a rented dwelling, dwelling in need of major repairs and working more than 40 hrs a week were also significantly associated with increased risk of ACO while female-specific risk factors significantly associated with increased risk of ACO included being widowed, separated or divorced, a current daily smoker and having a diagnosis of diabetes. The results from this study will offer useful evidence for future development of prevention and public health intervention programs in Aboriginal communities to reduce the burden of ACO.

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