Evaluation of the prevalence and risk factors of asthma, allergic rhinit, chronicobstructive lung disease in Azerbaijan

Background: Asthma, Allergic Rhinitis (AR), and Chronic Obstructive Pulmonary Disease (COPD) are treatable chronic airway diseases (CADs). The prevalence and risk factors for CADs are not well known in Azerbaijan. AZAAD (Azerbaijan Asthma and Allergy Research Group) was established for the field data collection phase of this study. The aim of the study is to examine the prevalence of CADs and its association with risk factors such as air pollution, atopy, occupation, smoking, biomass use, age, and gender in a representative sample of the Azerbaijani adult population. Methods: The research is a cross-sectional, epidemiological study conducted in urban and rural areas of Azerbaijan between 2019 and 2021. The interviewers visited selected homes and evaluated included subjects by the standard questionnaire of the ECRHS, spirometry (n=1384), and skin prick test (SPT, n=426) were applied to randomly selected participants. In the study, due to the negative effects of the Covid pandemic and the Azerbaijan-Armenia war, the number of spirometry (3600/1384) and skin prick tests (500/426) was slightly below than planned. Results: A total of 3788 individuals were enrolled. Average age was 36 (±15.9) years, 52.7% were women. Majority of the respondents were high school graduates (47.5%), married (60.7%), and workers (53.1%), current smoker (20,4%). The percent prevalence of asthma, AR, and COPD in men and women (M/W) were 2.5/ 3.5 (0.71 %95 CI; p=0.088), 35.5/38.6 (0.87 %95 CI; p=0.043) and 8.5/ 4.6 (1.93 %95 CI; p<0.001), respectively. The percent prevalence of asthma, AR, and COPD in Urban (Baku and Nakhchivan) and in Rural (rural of Baku and Nakhchivan) (U/R) areas were 2.7/ 3.7 (1.39 %95CI; p=0.087), 38.6, 33.9 (0.81 %95CI; p=0.006) and COPD 5.2, 9.2 (1.83 %95CI; p<0.001). The total prevalence percentage of asthma, asthma-like symptoms, and chronic bronchitis was 3%, 25.2%, and 6.5%, respectively. The most common symptoms of asthma in men and women (M/W) were wheezing 19%/ 16.7% (1.16 %95 CI; p=0.068), nocturnal cough 14.9%, 15.4% (0.96 %95CI; p=0.674), and chest tightness 8.9%/ 12% (0.71 %95CI; p=0.002). The most common symptoms of asthma in Urban and Rural (U/R) areas were wheezing 14.6%/ 24.8% (1.92 %95 CI; p<0.001), nocturnal cough 12.2%/ 21.8% (2 %95CI; p<0.001), and chest tightness 8.3%/ 15.4% (2 %95CI; p<0.001). Conclusion: The CAD's is an important public health problem. This is the first epidemiologic study that covers the prevalence of CADs and its associated risk factors in both urban and rural areas of Azerbaijan. The prevalence of chronic bronchitis was found to be significantly higher in males and in rural areas. There was no significant relationship between asthma and gender and between asthma and centers. The prevalence of AR was found higher in urban areas and in females.