Abstract Rationale Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition with different underlying causes (etiotypes). While COPD is well characterized in High-Income Countries (HIC), less is known about the distribution and characteristics of COPD etiotypes in Low- and Middle-Income countries (LMIC). In LMICs, risk factors such as air pollution, infections, and asthma are typically more prevalent. We aimed to understand COPD etiotypes in LMIC in terms of prevalence, demographic and clinical characteristics and burden (symptoms and healthcare utilization). Methods We did a post-hoc analysis of the Global Excellence in COPD Outcomes (GECo) study, a population-based study conducted in Nepal, Peru, and Uganda. COPD was categorized into five GOLD 2025 etiotypes: cigarette smoking (COPD-C), asthma-related (COPD-A), biomass and pollution-related (COPD-P), infection-related (COPD-I) and COPD of unknown causes (COPD-U). Results Among 1,003 participants in GECo with COPD, 50.3% had COPD-C, 26.7% COPD-A, 16.2% COPD-P, 8.3% COPD-I and 33.7% COPD-U, with significant overlap observed. COPD-C comprised mostly (84.4%) older males. COPD-A had more females (42.5%). COPD-P participants were the oldest (mean age 67.1 years), whereas COPD-I cases were the youngest (mean age 59.9 years). COPD-A was associated with the highest symptom burden by CAT and SGRQ scores 13.83(7.95), 44.5(27.6) Most severe lung function impairments were seen in COPD-A (–2.28) and COPD-I (–2.12), followed by COPD-P (–1.85) and COPD-C (–1.71). Conclusions In LMICs, COPD-C was most prevalent, followed by COPD-A and COPD-P etiotypes. COPD-A carried the greatest symptom burden. This abstract is funded by: Global Alliance for Chronic Diseases
Alupo et al. (2026) studied this question.