What is the prevalence of bronchiectasis in India?

Prevalence of Bronchiectasis in India

The prevalence of bronchiectasis in India is not precisely established through population-based studies, but data from the EMBARC/Respiratory Research Network of India Registry indicates it is a significant health burden with distinct characteristics compared to Western populations. 1

Epidemiological Data on Bronchiectasis in India

While exact prevalence figures specific to India are not available in the current literature, we can understand the burden through several key observations:

• In Western countries, bronchiectasis prevalence ranges from 53 to 566 cases per 100,000 inhabitants 2
• The Indian bronchiectasis registry enrolled 2,195 patients between 2015-2017 from 31 centers across India, suggesting a substantial disease burden 1
• Compared to European and US registries, Indian patients with bronchiectasis have distinct characteristics:
  • Younger median age (56 years vs. older in Western cohorts) 1
  • Higher proportion of male patients (56.9%) 1
  • Different etiology profile with post-tuberculosis being the predominant cause (35.5%) 1

Unique Features of Bronchiectasis in India

Etiology

• Previous tuberculosis is the most common cause (35.5%) in India 1
• This differs from Western countries where post-infectious causes are common but tuberculosis is less prevalent 3

Microbiology

• Pseudomonas aeruginosa is the most common organism isolated (13.7%) 1
• Gram-negative pathogens, particularly Klebsiella pneumoniae, are associated with increased mortality 4

Risk Factors for Poor Outcomes

Several factors are associated with worse outcomes in Indian patients:

• Frequent exacerbations (≥3 per year) 4
• Coexisting COPD 4
• Current cigarette smoking 4
• Pseudomonas aeruginosa infection 4
• History of pulmonary tuberculosis 4
• Male sex 1
• Daily sputum production 1
• Greater radiological severity 1

Diagnostic Challenges

The diagnosis of bronchiectasis in India faces several challenges:

• Low adherence to guideline-recommended diagnostic testing 1
• Only 388 patients in the registry were tested for allergic bronchopulmonary aspergillosis 1
• Only 82 patients had been tested for immunoglobulins 1

Clinical Implications

Understanding the prevalence and characteristics of bronchiectasis in India is important because:

• Patients in India tend to have more severe disease compared to Western cohorts 1
• Identification of risk factors can help optimize treatment approaches specific to the Indian setting 4
• There is a need for improved quality of care and adherence to diagnostic guidelines 1

The EMBARC/Respiratory Research Network of India Registry provides the most comprehensive data available on bronchiectasis in India, but population-based prevalence studies are still needed to determine the true burden of this disease in the Indian population.