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Published on: September 27, 2024
Chronic obstructive pulmonary disease in sub-Saharan Africa
B I Awokola1, G A Amusa2, C P Jewell3
1Centre for Health Informatics, Computing & Statistics (CHICAS), Lancaster Medical School, Lancaster University, Bailrigg, Lancaster, UK, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia.
Insights
Chronic obstructive pulmonary disease (COPD) is a major health issue in sub-Saharan Africa. Smoking significantly increases COPD risk, highlighting the need for targeted public health interventions.
Area of Science:
- Pulmonary Medicine
- Epidemiology
- Public Health
Background:
- Chronic obstructive pulmonary disease (COPD) is a leading cause of death globally and a significant contributor to mortality in sub-Saharan Africa (SSA).
- Understanding the prevalence and risk factors of COPD in SSA is crucial for developing effective public health strategies.
Purpose of the Study:
- To systematically review and analyze the prevalence of COPD in sub-Saharan Africa.
- To identify and quantify key risk factors associated with COPD in the region, with a focus on smoking.
Main Methods:
- A comprehensive systematic literature search was performed across multiple databases (MEDLINE, EMBASE, CINAHL, Global Health).
- Abstracts from thoracic conference proceedings (2017-2020) were manually searched to supplement the database search.
- A meta-analysis was conducted to determine the pooled prevalence of COPD and its association with current smoking.
Main Results:
- Out of 831 identified titles, 27 studies met the inclusion criteria for the review and meta-analysis.
- The pooled prevalence of COPD in SSA was found to be 8% (95% CI 6-11), with individual study prevalence ranging from 1.7% to 24.8%.
- Increased COPD prevalence was linked to older age, smoking, and exposure to biomass smoke. Current smoking showed a pooled odds ratio of 2.20 (95% CI 1.62-2.99) for developing COPD.
Conclusions:
- COPD significantly contributes to morbidity and mortality among adults in sub-Saharan Africa.
- Smoking is identified as a critical and modifiable risk factor for COPD in the region.
- Multidisciplinary efforts involving clinicians, researchers, and policymakers are essential to reduce smoking exposure and combat COPD.
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.
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