Spatial analysis of chronic obstructive pulmonary disease and its risk factors in an urban area of Trivandrum, Kerala, India

Background: Chronic obstructive pulmonary disease (COPD) is the second leading cause of death in India. The objective of this study was to map COPD cases and its risk factors and to determine the association between them using geographic information system (GIS) in a semi-urban area of Trivandrum, South India. Materials and Methods: This community-based cross-sectional, descriptive study (n = 494) was conducted in a subcenter area of a primary health center. Location was mapped and COPD population screener questionnaire was administered to all the study subjects enrolled by census method. Lifetime firewood exposure (person-hours) and tobacco smoking were enquired and distance from road was mapped using portable differential global positioning system. The association with COPD was assessed by kriging and hotspot analysis using ArcGIS software. Results: The prevalence of COPD (6.5%) was comparable to national prevalence estimates. Spatial maps showed COPD case clustering in areas with higher firewood exposure, greater smoking exposure, and in households with closer proximity to local roads. A particular high-risk cluster was obtained which had a significant association with all the risk factors. Conclusion: GIS technology is useful in identification of spatial clustering of COPD cases and its environmental risk factors, making it an important tool for targeted interventions for COPD.