Spirometry in Uncharted Territories: Pioneering COPD Monitoring in Urban Slums

Background: In many developing countries, including Bangladesh, the prevalence of Chronic Obstructive Pulmonary Disease (COPD) is rising, with significant impact on public health systems and communities. In resource-limited urban settings, the challenge is compounded by inadequate access to diagnostic tools like spirometry. Aim: The primary aim of this study is to explore and evaluate innovative, cost-effective spirometry technologies suitable for use in resource-constrained urban areas, with a view to enhancing the diagnosis, monitoring, and management of COPD. Methods: A mixed-methods approach was employed, combining quantitative data from spirometry tests with qualitative interviews of patients. A portable spirometry device was introduced in selected urban slums of Dhaka. Training sessions were conducted for the healthcare team to operate the device and interpret results. Patient data was collected over a 6-month period, alongside qualitative assessments of device efficacy, user-friendliness, and practical challenges in these settings. Results: Out of 54 patients who were tested using the spirometry machine, 30 were conclusively diagnosed with COPD. This subgroup was part of the broader initial group, representing a diverse cross-section of the urban slum populations. From the diagnosed group a cohort of 7 primary level-educated patients were selected belonging to 7 different slums, for follow-up interviews with a WHOQL-BREF questionnaire. Preliminary findings indicate that the use of adapted spirometry device was feasible and effective in improving COPD diagnosis and monitoring in urban slums. Challenges included maintaining device calibration, ensuring consistent patient access, and adapting to various environmental conditions. Conclusion: Adapting spirometry technology for use in resource-limited settings shows promise for enhancing COPD management in urban slums. This approach, coupled with appropriate training and community engagement, has the potential to bridge significant gaps in respiratory care in developing urban areas. Further research and investment are needed to optimize these technologies for wider deployment.