Chronic obstructive pulmonary disease in sub-Saharan Africa

Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and an important cause of death in sub-Saharan Africa (SSA). We conducted a systematic review and meta-analysis on the prevalence of and risk factors for COPD in SSA.METHODS: We conducted a protocol-driven systematic literature search in MEDLINE, EMBASE, CINAHL and Global Health, supplemented by a manual search of the abstracts from thoracic conference proceedings from 2017 to 2020. We did a meta-analysis of COPD prevalence and its association with current smoking.RESULTS: We identified 831 titles, of which 27 were eligible for inclusion in the review and meta-analysis. The population prevalence of COPD ranged from 1.7% to 24.8% (pooled prevalence: 8%, 95% CI 6–11). An increased prevalence of COPD was associated with increasing age, smoking and biomass smoke exposure. The pooled odds ratio for the effect of current smoking (vs. never smoked) on COPD was 2.20 (95% CI 1.62–2.99).CONCLUSION: COPD causes morbidity and mortality in adults in SSA. Smoking is an important risk factor for COPD in SSA, and this exposure needs to be reduced through the combined efforts of clinicians, researchers and policymakers to address this debilitating and preventable lung disease.

Prevalence and determinants of chronic respiratory diseases in adults in Khartoum State, Sudan

“…Older age was the main risk factor for CAO in our study, which is consistent with both regional and global findings 7,9,16,18 . The absence of an association with CAO and cigarette smoking might be due to that 50% of the smokers in our study reported a smoking history of ≤ 10 pack-years.…”

“…The determined prevalence of spirometric obstruction is consistent with that in similar studies from sub-Saharan Africa, where the prevalence of smoking is high 16 . Previous BOLD studies reported COPD prevalence of 23% in men and 16.9% in women in South Africa 17 and 7.7% in Nigeria 7,18,19 . CAO prevalence reported from a multinational BOLD study was 11.5% in men and 8.8% in women which is consistent with our findings 20 .…”

“…Prevalence estimates for COPD in sub-Saharan Africa (SSA) 5,6 are based on limited epidemiological data which lack a standardized definition of COPD. A recent systematic review reported a population prevalence of COPD in SSA ranging from 1.7% to 24.8% 7 .…”

Identifying risk factors for COPD and adult-onset asthma: an umbrella review

“…We identified 19 reviews, studying six different risk factors [ 46 , 54 , 57 , 60 , 61 , 64 , 69 , 70 , 72 , 76 , 77 , 79 , 81 – 83 , 85 , 86 , 93 , 94 ]. P ark et al .…”

“…[ 82 ], with a 10 μg·m -3 increase in NO 2 being associated with an mHR of 1.07 (95% CI 1.00–1.16) [ 60 ] and an mRR of 1.02, respectively. Indoor air pollution caused by indoor biomass burning was found to be a risk factor for COPD in several reviews [ 54 , 57 , 61 , 69 , 70 , 72 , 76 , 77 , 79 , 81 , 83 , 85 , 86 , 93 , 94 ]. Found mORs ranged between 1.52 (95% CI 1.39–1.67), found by N joku et al .…”