Evidence for pulmonary rehabilitation in chronic respiratory diseases in sub-Saharan Africa: a systematic review

Abstract

BACKGROUND: Pulmonary rehabilitation (PR) is a highly effective non-pharmacological treatment for patients with chronic respiratory diseases.OBJECTIVE: To synthesise the evidence for PR practice and efficacy in sub-Saharan Africa.METHODS: We searched in PubMed and Scopus for relevant studies and scanned reference lists of relevant studies from these databases for additional studies. Articles meeting the inclusion criteria were included. Pre-determined data were extracted independently by two reviewers. A narrative synthesis approach was used in the interpretation of findings.RESULTS: Six studies were included, totalling 275 participants. Indications for PR were chronic obstructive pulmonary disease, asthma, pulmonary tuberculosis and post-tuberculosis lung disease. Programmes ran for 6–12 weeks, universally incorporated exercise, and variously used home-based and hospital-based delivery models. All were interventional studies, of which two were randomised controlled trials, and primarily reported pulmonary function and exercise tolerance endpoints. Evidence for individualising the exercise regimen was available in three studies.CONCLUSIONS: There is limited evidence on PR design and efficacy in sub-Saharan Africa, but available data support its use in a variety of chronic respiratory conditions. Future studies should report core outcome sets and their individualised exercise and education regimens.

The Development of Support for People Following COVID-19 Infection in Kyrgyzstan: Survey Study of Patients and Clinical Workers

“…There is now a large amount of data on the long-term symptoms experienced by COVID-19 survivors after being discharged from the hospital. An Italian study that followed 143 patients 7 weeks after discharge found that 53% of patients reported fatigue, which is similar to our data, 43% reported shortness of breath, 27% reported joint pain and 22% reported chest pain [15]. In a similar study in the UK, fatigue associated with a new illness was the most common symptom, reported by 72% of participants in the intensive care group and 60.3% of participants in the ward group.…”

Barriers and Enablers to Pulmonary Rehabilitation in Low- and Middle-Income Countries: A Qualitative Study of Healthcare Professionals

“…Participants were purposively recruited with the inclusion criteria being healthcare professionals with experience in implementing or delivering PR in LMICs. Participants were identified from papers included in two recent systematic reviews on PR in low resource settings, 14,25 and the Global RECHARGE network. 26 Recruitment emails were sent to the corresponding authors of the papers, along with a consent form, participant information sheet and request to disseminate the invitation to their colleagues.…”

Barriers and enablers to pulmonary rehabilitation in low- and middle-income countries: a qualitative study of healthcare professionals

“…Participants were purposively recruited with the inclusion criteria being healthcare professionals with experience in implementing or delivering PR in LMICs. Participants were identi ed from papers included in two recent systematic reviews on PR in low resource settings 14,25 , and the Global RECHARGE network 26 . Recruitment emails were sent to the corresponding authors of the papers, along with a consent form, participant information sheet and request to disseminate the invitation to their colleagues.…”