The burden of chronic respiratory diseases in adults in Nepal: A systematic review

Winifred Ekezie, Alex Robert Jenkins, Ian Phillip Hall, Catrin Evans, Rajendra Koju, Om Kurmi, Charlotte Emma Bolton

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    While chronic lung disease causes substantial global morbidity and mortality, global estimates have primarily been based on broad assumptions. Specific country data from low-income countries such as Nepal are limited. This review assessed primary evidence on chronic respiratory disease burden among adults in Nepal. A systematic search was performed in June 2019 (updated May 2020) for studies through nine databases. High levels of heterogeneity deemed a narrative synthesis appropriate. Among 27 eligible studies identified, most were low-moderate quality with cross-sectional and retrospective study design. Chronic lung diseases identified were chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and restrictive lung diseases. Studies were categorised as: (i) community-based, (ii) hospital-based and (iii) comorbidity-related and disease burden. Reported disease prevalence varied widely (COPD, 1.67–14.3%; asthma, 4.2–8.9%). The prevalence of airflow obstruction was higher among rural dwellers (15.8%) and those exposed to household air pollution from domestic biomass burning as opposed to liquid petroleum gas users (Odds Ratio: 2.06). Several comorbidities, including hypertension and diabetes mellitus added to the disease burden. The review shows limited literature on lung disease burden in Nepal. Publications varied in terms of overall quality. Good quality research studies with prospective cohorts related to respiratory conditions are required.
    Original languageEnglish
    Number of pages20
    JournalChronic Respiratory Disease
    Early online date6 Jul 2021
    Publication statusPublished - 2021

    Bibliographical note

    This article is distributed under the terms of the Creative Commons Attribution 4.0 License
    ( which permits any use, reproduction and distribution of the work without further
    permission provided the original work is attributed as specified on the SAGE and Open Access pages (


    The systematic review was supported by the “Global Challenges Research Fund”, University of Nottingham 2018-2019.


    • Chronic respiratory disease
    • lung function
    • prevalence
    • Nepal
    • global lung health

    ASJC Scopus subject areas

    • Pulmonary and Respiratory Medicine


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