A Questionnaire to Screen Chronic Obstructive Respiratory Diseases in a Low-medium Income Country: a Cross – Sectional Study

Abstract

Abstract Background chronic obstructive respiratory diseases (CORD) can lead to severe morbidity and mortality but is preventable at an early stage. Spirometry is the keystone for early diagnosis but is not widely available in Vietnam. The study aims to develop a questionnaire to screen the patients requiring spirometry. Methods this cross – sectional study included consecutive volunteers, visiting the District 10 and District 12 hospitals, HCMC, Vietnam. Based on chronic clinical symptoms, history of tuberculosis, chronic bronchitis, asthma and occupation risks, cumulative smoking and exposures to indoor pollution factors, a questionnaire was developed and submitted to each subject. A spirometry was also obtained, CORD being defined by airways' obstruction with FEV1/FVC < LLN. A multivariate model was applied, including all parameters having reached statistical significance in univariate analysis to determine the statistically significant variables as possible CORD predictors. Results 1877 subjects were recruited from June 2019 to June 2021. The prevalence of CORD was 16% (n = 300). Among the 267 subjects with history of asthma, 153 had measured airways' obstruction (OR = 14; 95%CI 10–18). Among the 1610 subjects with no history of asthma, there were 147 CORD (9%). Among those subjects, based on ROC curve analysis, the best predictors of CORD were the cumulative smoking, history of tuberculosis, current breathless and wheezing or whistling, with relative sensitivity (57%) and higher specificity (82%). Conclusion among the non asthmatic population, a questionnaire based on 4 items can identify less than 10% of subjects, requiring spirometry to diagnose airways' obstructive diseases.