Estimated prevalences of respiratory symptoms, asthma and chronic obstructive pulmonary disease related to detection rate in primary health care

Objective - To assess the prevalence of respiratory symptoms, asthma and ch ronic obstructive pulmonary disease (COPD), and to relate it to an estimate d detection rate in primary health care. Design - A two-staged study with a cross-sectional survey and a clinical va lidation. Setting - The adult population of Varmland, a county in Sweden. Subjects - 4814 persons completed the survey and 206 the confirmative valid ation study. Main outcome measures - Prevalence of respiratory symptoms, of asthma and C OPD. Results - More than 40% reported respiratory symptoms. Wheeze was reported by 8.0%, shortness of breath by 11.4% and sputum production by 14.1%. Smoki ng was more common among women than among men. The prevalence of asthma was 8.2% and COPD 2.1%. Of persons with asthma, 33% were estimated to be undia gnosed, 67% used medication and nearly 60% attended primary health care ser vices. Conclusion - Respiratory symptoms as well as asthma were common in this stu dy and equivalent to earlier findings. The difference between the epidemiol ogically estimated prevalence of asthma and the lower detection rate in pri mary health care can be explained by at least three factors: persons who di d not seek any care, were underdiagnosed or attended other health care prov iders.