Prevalence and factors associated with respiratory symptoms in an urban population: findings from BOLD study in Karachi, Pakistan.

Objective: Our study investigated the prevalence and risk factors of respiratory symptoms (RS) in an adult population aged ≥ 40 years in urban Karachi, Pakistan. Methods: A population based cross-sectional study was conducted. Multi-stage cluster random sampling technique was used to enroll 1052 participants. Questionnaire based on the Burden of Obstructive Lung Disease (BOLD) study protocol was used to assess chronic cough, chronic phlegm, wheezing and shortness of breath (SOB). Logistic regression analyses were conducted to determine the risk factors associated with RS. Results: The overall weighted prevalence of RS in our study was; chronic cough: 12% (95% CI: 9.7-14.8), chronic phlegm: 11.8% (95% CI: 9.4-14.7), wheezing in last 12 months: 11.5% (95% CI: 9.4-14.0), and shortness of breath (SOB): 30.4% (95% CI: 25.6-35.7). Increasing age and ever smoker were significant risk factors for all RS. Females had higher risk of chronic cough. Lower level of education and higher BMI were associated with wheezing and SOB. Exposure to passive smoking was found to be significant risk factor for SOB. Conclusion: We found a higher prevalence of respiratory symptoms among adult population in urban Karachi, specifically about 30.4% reported shortness of breath (SOB). Certain preventable risk factors (smoking and being exposed to passive smoking) were identified. Targeted interventions such as community education and localized air quality monitoring could help mitigate the burden of respiratory symptoms. Supplementary Information: The online version contains supplementary material available at 10.1007/s44337-025-00432-4.