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

Abstract

Introduction This study estimates the prevalence of chronic pulmonary disease defined by spirometry in urban Khartoum and identifies the impact of risk factors on the prevalence of the disease. Methods Nine hundred and ninety-eight subjects aged 40 years or older from three localities in Khartoum were enrolled in this cross-sectional survey. A field worker collected questionnaire data and performed pre and post-bronchodilator spirometry tests. Survey weighted prevalence estimates of respiratory symptoms and spirometric abnormalities were computed. Bivariate and multivariable regression analyses were used to identify associated variables. Results Full questionnaire and spirometry data were collected from 516 subjects. Using the National Health and Nutrition Examination Survey 1988-1994 reference range for white Americans, the prevalence of Chronic Airflow Obstruction (CAO) according to the lower limit of normal (LLN) was 10% (standard error [SE] 1.4). The main risk factor for CAO was older age of 60-69 years (odds ratio 3.16, 95% confidence interval 1.20-8.31). Other risk factors such as low level of education, high body mass index and having a history of tuberculosis were also identified. The prevalence of a low forced vital capacity (FVC) using the NHANES reference range was 62.7% (SE 2.2) and 11.3% [SE 1.4] using internally derived local values. Discussion The prevalence of spirometric abnormality; mainly (low FVC) was high suggesting that chronic lung disease is of substantial public health importance in urban Sudan. Consideration from the public health and health system strengthening for the prevention and control of these problems is highly needed.

Prevalence and determinants of chronic respiratory diseases in adults in rural Sudan

“…Building on an earlier BOLD study conducted in urban Sudan, 6 we conducted this population-based study in Gezira State to explore CRD symptoms and spirometric abnormalities in adults in rural Sudan.…”

“…These are lower than 10% and 5.7% from recent findings of an urban study in Sudan using NHANES and local reference equations, respectively. 6 …”

“…These were derived from non-smoking Sudanese adults with no respiratory symptoms or diagnoses in the previous urban study. 6 …”

“… 4 High prevalence of chronic airflow obstruction (CAO) has been documented across the region, 5 with spirometric obstruction seen in 10% of urban Sudanese adults in a recent study. 6 The prevalence and underlying causes of low forced vital capacity (FVC) in SSA remain poorly understood; 7 nonetheless, its association with mortality is well-documented. 8 TB, early childhood infection, low body mass index, biomass fuel use, smoking and poverty are believed to be associated with CRDs in LMICs.…”

“… 13 The Burden of Obstructive Lung Disease (BOLD) Initiative developed standardised methods for estimating the burden and determinants of CAO in populations aged ≥40 years. 14 , 15 Following an urban study in Khartoum State, 6 we conducted a population-based cross-sectional (BOLD) study in rural Gezira State, Sudan, to explore the prevalence and determinants of CRD symptoms and spirometric abnormalities among adults in rural Sudan.…”