The burden of COPD in Africa: a literature review and prospective survey of the availability of spirometry for COPD diagnosis in Africa

Abstract

Summaryobjectives To ascertain the known burden of chronic obstructive pulmonary disease (COPD) in Africa and of spirometry use to indicate the possibility of further unpublished data becoming shortly available.method Literature review. results Screening of 132 articles yielded 22 relevant articles, of which only six used spirometry based data. A total of 106 physicians in 34 countries were contacted and only 23 reported satisfactory use and availability of spirometry.conclusions Current estimates of COPD burden in Africa are based on an unreliably small dataset. Acquisition of further data will require substantial investment in lung function equipment and training.

Global and regional estimates of COPD prevalence: Systematic review and meta–analysis

“…Several authors have reported that the epidemiological evidence on COPD in African region is still very limited and that this has affected the response to its growing burden in the region [16,34,163,164]. We estimated a prevalence of about 11% in 2010, amounting to 29 million COPD cases in the region.…”

“…The burden in LMIC has been comparatively high owing to relatively low COPD awareness, challenges with COPD diagnosis and increased exposures to additional risk factors, especially combustion products of biomass fuels [16]. Salvi and colleagues reported that about 3 billion people globally are exposed to smoke from biomass fuel, compared to 1 billion people who smoke tobacco globally [17].…”

“…As noted above, this initiative is yet to take a full effect in many LMIC [19]. In addition, spirometry (the gold standard for COPD diagnosis) is not widely available in many LMIC [16]. Even when it is there, professionals in LMIC are often not being trained properly on how to use spirometers or interpret spirometry results.…”

The impact of asthma and COPD in sub-Saharan Africa

“…37,39 In other surveys, no bronchodilator was administered or spirometry was not available so the diagnosis was made using symptoms such as shortness of breath, cough, and sputum production for more than three months over the previous two years. 12 Only 10 of the 53 countries in Africa have published data on the prevalence of COPD (e.g. selected populations such as factory workers and miners).…”

“…11 Data on CRD and related risk factors are scarce or not available for most developing countries, and only few data on morbidity and economic burden exist, particularly in subSaharan Africa. 12 Information on causes of death among adults in sub-Saharan Africa is essentially non-existent because death certificates are often not issued. 8 …”