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Prevalence, risk factors and clinical correlates of COPD in a rural setting in Tanzania

Lookup NU author(s): Professor Richard Walker, Dr Anil Namdeo

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by European Respiratory Society, 2018.

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Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) causes substantial burden of disease in developed countries but there is limited data from Africa. Objective: We aimed to estimate the prevalence of COPD in Tanzania and identify the risk factors associated with it. Methods: This was a cross-sectional descriptive survey involving adults aged ≥35 years. We collected data on symptoms and risk factors using the BOLD questionnaire. Spirometry was performed and COPD diagnosed based on post-bronchodilator FEV1/FVC<70%. We also measured indoor and outdoor CO levels. Results: A total of 869 participants (49・1% women) completed the questionnaires. Of these 57.1% completed post-bronchodilator spirometry. Of the 25.2% ever smokers, only 5.4% were current smokers. COPD prevalence was estimated at 17・5% ⦋21・7% in men, 12・9% in women]. COPD was associated with history of cough, phlegm production and wheezing. 51.7% of COPD patients reported cough and 85% had mild-to-moderate airway limitation. Women had a higher rate of exacerbation. Pulmonary tuberculosis was reported in 10% of patients. Only 1.7% of patients who were diagnosed as COPD had ever received any medication, with only 1 female COPD patient having received an inhaler. 99.5% of the population used biomass fuels for cooking. The majority of households revealed up to 20ppm of CO levels. Conclusion: The prevalence of COPD in Tanzania is high, with a peak at a younger age and preponderance in men. A history of tuberculosis, cigarette smoking and the male gender are important risk factors. Indoor air pollution and use of biomass for cooking and heating may be an important risk factor for developing COPD in rural Tanzania. However, these factors need to be studied further.


Publication metadata

Author(s): Magitta N, Walker R, Apte Ki, Shimwela M, Mwaiselage J, Sanga A, Namdeo A, Madas S, Salvi S

Publication type: Article

Publication status: Published

Journal: European Respiratory Journal

Year: 2018

Volume: 51

Issue: 2

Online publication date: 31/01/2018

Acceptance date: 06/11/2017

Date deposited: 23/02/2018

ISSN (print): 0903-1936

ISSN (electronic): 0903-1936

Publisher: European Respiratory Society

URL: https://doi.org/10.1183/13993003.00182-2017

DOI: 10.1183/13993003.00182-2017


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