Community-based screening for impaired expiratory airflow using portable peak flow measurement among rural adults in western India: prevalence, risk factors, and implications for primary-care respiratory screening

Chronic respiratory diseases (CRDs) substantially contribute to India’s non-communicable disease burden, especially in rural populations. Peak expiratory flow rate (PEFR) is useful for community-based respiratory screening in resource-limited settings. This community-based cross-sectional study assessed the prevalence and risk factors of impaired expiratory airflow among rural adults aged ≥30 years in Western India. Data were collected through house-to-house visits using a structured questionnaire administered by trained ASHA workers. Information regarding sociodemographic, environmental risk factors and comorbidities was obtained. PEFR was measured using peak flow meters following standard guidelines. A total of 11,359 rural adults participated in the study. Overall, 9.17% of participants had suspected PEFR impairment. The prevalence of PEFR impairment was significantly higher among older adults, males, smokers, underweight individuals, participants using unclean cooking fuel, and those with CRDs, hypertension, or diabetes mellitus. Community-based PEFR screening conducted by ASHA workers may represent a cost-effective strategy for early identification of airflow limitation in rural primary-care settings.