Chronic obstructive pulmonary disease (COPD) causes substantial burden of disease in developed countries, but there are limited data from Africa. We aimed to estimate the prevalence of COPD in Tanzania and identify the risk factors associated with it.This was a cross-sectional descriptive survey involving adults aged ≥35 years. We collected data on symptoms and risk factors using the Burden of Obstructive Lung Diseases questionnaire. Spirometry was performed and COPD diagnosed based on post-bronchodilator forced expiratory volume in 1 s/forced vital capacity <70%. We also measured indoor and outdoor carbon monoxide (CO) levels.A total of 869 participants (49.1% females) 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 males and 12.9% in females). COPD was associated with a history of cough, phlegm production and wheezing. 51.7% of COPD patients reported cough and 85% had mild to moderate airway limitation. Females had a higher rate of exacerbation. Pulmonary tuberculosis (TB) was reported in 10% of patients. Only 1.7% of patients who were diagnosed as COPD had ever received any medication, with only one female COPD patient having received an inhaler. 99.5% of the population used biomass fuels for cooking. The majority of households had CO levels up to 20 ppm.The prevalence of COPD in Tanzania is high, with a peak at a relatively young age and a preponderance in males. A history of TB, cigarette smoking and male sex are important risk factors. Indoor air pollution coupled with use of biomass fuel for cooking and heating may be an important risk factor for developing COPD in rural Tanzania. However, these factors need to be studied further.

Background: COPD is an important public health problem globally. To-date, indoor air pollution resulting from biomass fuel use is an important risk factor for COPD, particularly in Africa. The poor communities in informal settlements in major cities are likely to be exposed to higher pollution rates and could disproportionately develop COPD. Methods: We collected demographic data, respiratory symptoms and exposure history to air pollution using BOLD validated questionnaire and further performed spirometry using NDD EasyOneTM spirometer, with COPD diagnosed based on a post-bronchodilator FEV1/FVC <70%. The study was approved by the National Ethics committee. Results: A total of 1021 participants completed the questionnaire and had acceptable post-bronchodilator spirometry [(861 female, 66.70%)], with mean age of 52.16 ± 11.59 years. About 15.48% of respondents were smokers, of whom 6.46% were current smokers and 16.67% had significant nicotine dependency. Of all respondents, 11.71% reported living with a smoker and 5.31% reported a history of tuberculosis. The overall prevalence of COPD was estimated at 8.13% [(14.2% male, 5.14% female)], and found to be associated with age (p =0.005), gender (p=0.001), BMI (p=0.001) and smoking status (p=0.001). Over 98% of respondents reported significant exposure to biomass fuel. Over 78% of COPD patients had mild to moderate obstruction and the female had comparatively severe obstruction.Conclusion: In this population, COPD is relatively low compared to previous reports in Africa. Though multiple risk factors are responsible for COPD development, indoor pollution remains the most important factor. In this regard, access to affordable clean energy for domestic use is the most important strategy for COPD control.

Background: There is a substantial burden due to Chronic Obstructive Pulmonary Disease (COPD) contributes to a substantial burden of diseases in developed countries. The existing unregulated mining activities in Africa, often without proper protective gear, could expose miners to excessive air pollution levels and subsequent development of COPD. Methods: We conducted a case – control study in small-scale, informal, hard-rock mining site in Northern Tanzania. We recruited all eligible active miners and ex-miners and matched non-miners aged ≥30 years. We collected data on respiratory symptoms and risk factors using the BOLD questionnaire and performed spirometry with COPD defined based on post-bronchodilator FEV 1 /FVC<70%. We monitored air pollution based on PM 10 level in underground mining pits using TSI Side Pak TM AM510 samplers. Results: A total of 851 men ⦋577 active miners, 211 ex-miners and 63 non-miners⦌ were recruited with a mean age of 40.95 ± 9.21 years and two-thirds were cigarette smokers. About 83% of all respondents completed the questionnaires and underwent post-bronchodilator spirometry. The prevalence for COPD was estimated at 15.20%, 17.10% and 15.40% for active miners, ex-miners and non-miners respectively. Over 18% of current cigarette smokers had significant nicotine dependence which was associated with the duration of smoking (p= 0.028) and the number of pack years (p= 0.002). The majority of COPD patients presented with cough and had frequent exacerbations but with mild to moderate airway limitation. The majority of ex-miners presented with dyspnoea and had poor FEV 1 and FVC parameters. About 25% of COPD patients reported a history of pulmonary tuberculosis. The survey revealed up to 20000µg/m 3 of PM 10 in the underground drilling points; 400-fold higher than the acceptable WHO limits. Conclusion: There is high prevalence of COPD among small-scale miners in Tanzania. The patients are largely young and many are smoking cigarettes. The mining activities are typically carried out without protective gear. There is widespread lack of awareness of COPD and often people received inappropriate diagnosis and therapy.

BackgroundSub-optimal diets are the primary risk factor for mortality among pregnant women. In Tanzania, many pregnant women have micronutrient deficiencies in iron, iodine, and vitamin A. Promoting healthy diets, with a focus on food quality and the consumption of fortified foods, may help to reduce mortality amongst pregnant women. However, more evidence is needed to inform the development of effective food based approaches. The aim of the study was to evaluate associations between demographic and socioeconomic factors with diet quality among pregnant women in Mbeya, Tanzania. MethodsData from a cross-sectional study conducted, in 2020, in Mbeya which included a population-based sample of 420 pregnant women was analyzed. Dietary intake was assessed using the Prime Diet Quality Score (PDQS) with data from 24-HR diet recalls. Socioeconomic variables were also collected. Chi square-tests and one way ANOVAs were used to assess differences across demographic and socio-economic predictors of PDQS. Multivariate analyses were conducted to adjust for confounders and effect modifiers. All tests were two-tailed and significance level was set at 5%. ResultsStudy participants had a mean age of 25.49 ± 6.37 years. The mean PDQS was 16.2±2.7. For the PDQS, the consumption of at least 4 servings per week of food groups was as follows: dark green leafy green vegetables (29.2%), other vegetables (14.7%) and vegetable liquid oil (57.2%). Consumption of refined grains was high (48.0%). Pregnant women who visited antenatal clinics (ANC) had a reduced diet quality. Occupational status and household wealth index were significantly associated with PDQS in high quintile groups. Marital status was negatively associated with the PDQS and, pregnant women who reported to visit ANC were positively associated with PDQS. ConclusionsPregnant women aged 15-49 years in Mbeya region have low PDQS scores due to high intakes of refined grains, limited consumption of red meats, and low intakes of healthy cruciferous vegetables, whole citrus fruits and poultry. These findings suggest that public health action is needed to improve diet quality amongst pregnant women to improve health outcomes of this population.