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Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)

Author

Listed:
  • Ta-Chien Chan

    (Research Center for Humanities and Social Sciences, Academia Sinica, Taipei 115, Taiwan)

  • Hsuan-Wen Wang

    (Division of Family Medicine, Fangliao General Hospital, Pingtung 940, Taiwan)

  • Tzu-Jung Tseng

    (Research Center for Humanities and Social Sciences, Academia Sinica, Taipei 115, Taiwan
    Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei 242, Taiwan)

  • Po-Huang Chiang

    (Institute of Population Health Sciences, National Health Research Institutes, Zhunan 350, Taiwan
    Department of Public Health, China Medical University, Taichung 400, Taiwan)

Abstract

Chronic obstructive pulmonary disease (COPD) mortality has been steadily increasing in Taiwan since 2009. In order to understand where the hotspot areas are and what the local risk factors are, we integrated an ecological and a case-control study. We used a two-stage approach to identify hotspots and explore the possible risk factors for developing COPD. The first stage used the annual township COPD mortality from 2000 to 2012 and applied the retrospective space-time scan statistic to calculate the local relative risks in each township. In the second stage, we conducted a case-control study, recruiting 200 patients from one local hospital within the one identified hotspot area located in southern Taiwan. Logistic regression was applied for analyzing the personal risk factors of COPD. The univariate analyses showed that higher percentages of aborigines, patients with tuberculosis (TB) history, and those with smoking history had COPD ( p < 0.05). After controlling for demographic variables, aboriginal status (adjusted odds ratios (AORs): 3.01, 95% CI: 1.52–5.93) and smoking history (AORs: 2.64, 95% CI: 1.46–4.76) were still the two significant risk factors. This two-stage approach might be beneficial to examine and cross-validate the findings from an aggregate to an individual scale, and can be easily extended to other chronic diseases.

Suggested Citation

  • Ta-Chien Chan & Hsuan-Wen Wang & Tzu-Jung Tseng & Po-Huang Chiang, 2015. "Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)," IJERPH, MDPI, vol. 12(12), pages 1-12, December.
    • Handle: RePEc:gam:jijerp:v:12:y:2015:i:12:p:15014-15727:d:60351
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    References listed on IDEAS

    as
    1. Chih-Hsin Lee & Ming-Chia Lee & Hsien-Ho Lin & Chin-Chung Shu & Jann-Yuan Wang & Li-Na Lee & Kun-Mao Chao, 2012. "Pulmonary Tuberculosis and Delay in Anti-Tuberculous Treatment Are Important Risk Factors for Chronic Obstructive Pulmonary Disease," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-8, May.
    2. Maria B Ospina & Don Voaklander & Ambikaipakan Senthilselvan & Michael K Stickland & Malcolm King & Andrew W Harris & Brian H Rowe, 2015. "Incidence and Prevalence of Chronic Obstructive Pulmonary Disease among Aboriginal Peoples in Alberta, Canada," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-13, April.
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    Keywords

    COPD; SaTScan; smoking; aborigines; Taiwan;
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