A study shows most ILDs here are treatable Pigeon exposure, contaminated air-conditioner and Old air-cooler exposures triggers ILD in India
Interstitial Lung Disease (ILD), a lung disease predominant and common in a country like India has become a major-medical burden for the country. A country which always relied on international data to treat and understand ILD now needs medical attention to combat the problem. But ILD India registry data is going to change that attitude for-ever. Based on a recent study, the hope has floated high that accurate early diagnosis can cure Indian ILD patients. The study has found that most of ILDs in India are treatable.
The study was done under the aegis of Dr. Virendra Singh from Asthma Bhawan, Jaipur in collaboration with world’s renowned ILDcenter at Seattle, America to list and create awareness to address the disease which has been neglected for decades. The study was conducted across India.
Over 1084 patients diagnosed with respiratory problems were screened for Hypersensitivity Pneumonitis, Idiopathic Pulmonary fibrosis, Nonspecific Interstitial pneumonia, cryptogenic organizing pneumonia and Connective tissue associated ILD. The study revealed that Hypersensitivity Pneumonitis (HP) 47.3%, Connective tissue associated ILD (CTD-ILD) in 13.9%, Idiopathic pulmonary fibrosis (IPF) in 13.7%, non specific interstitial pneumonia (NSIP) in 8.5%, sarcoidosis in 7.8%, cryptogenic organizing pneumonia (COP) in 3.1%, pneumoconiosis in 3% and other ILD’s in 5.7% cases were predominant.
The incidence of HP in the current ILD India registry was higher than that reported by earlier Indian and international studies which needs our attention now. Though the study was not designed to establish a cause effect relationship, birds like pigeons, contaminated air-conditioners and Old air-cooler exposure was more evident in the HP group rather than the other ILD group. Chances of HP with pigeon exposure were 3 times more, with contaminated air-conditioner exposure almost 2 times and with air-cooler exposure there were 1.5 times.
Talking more about the under diagnosed disease, Dr Sheetu Singh the lead author says, “ILD in India has been neglected because of the high end screening procedure that is involved for the diagnosis. ILD is recognised only with good-quality HRCT scanning machines and the scarcity of trained radiologists skilled in reporting these scans. It can be also diagnosed after lung biopsy, but the affordability of the diagnosis scare the patients”.
In a country as populous (1.31 billion people) and diverse asIndia, it is essential to ascertain the breakup of the different ILDs and attempt some estimate of the population prevalence.
Sadly, India is still a developing country, with less than a fifth of its patients having medical insurance and with the government spending 1% of its GDP on public health (10), amounting to $40 per person annually on healthcare (the equivalent amount in the United States is $8,500). Thus, even an oxygen concentrator, considered a basic requirement for most patients with advanced fibrotic lung disease in the Western world, is still an unaffordable luxury for the vast majority of Indian patients. Yet India is a land of paradox: the antifibrotic drug pirfenidone has been available since 2010, 4 years before its launch in the United States.
What is ILD?
When we breathe air goes from wind pipe to distal sacs called alveoli. Through alveolar walls, oxygen taken in the breath diffuses in to blood while carbon oxide of blood enters in to alveolar air. In ILD patients alveolar walls are swollen and scarred. Due to this structural defect less oxygen is delivered in the blood from alveolar air. Such a patient is usually normal at rest but feel breathless on walking and exertion. Irritating dry cough is very distressing in these patients. When disease is advanced patient is breathless even in resting position and require oxygen