Abstract
In Tunisia, there is a paucity of population-based data on Chronic Obstructive Pulmonary Disease (COPD) prevalence. To address this problem, we estimated the prevalence of COPD following the Burden of Lung Disease Initiative. We surveyed 807 adults aged 40+ years and have collected information on respiratory history and symptoms, risk factors for COPD and quality of life. Post-bronchodilator spirometry was performed and COPD and its stages were defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Six hundred and sixty one (661) subjects were included in the final analysis. The prevalence of GOLD Stage I and II or higher COPD were 7.8% and 4.2%, respectively (Lower Limit of Normal modified stage I and II or higher COPD prevalence were 5.3% and 3.8%, respectively). COPD was more common in subjects aged 70+ years and in those with a BMI < 20 kg/m2. Prevalence of stage I+ COPD was 2.3% in <10 pack years smoked and 16.1% in 20+ pack years smoked. Only 3.5% of participants reported doctor-diagnosed COPD. In this Tunisian population, the prevalence of COPD is higher than reported before and higher than self-reported doctor-diagnosed COPD. In subjects with COPD, age is a much more powerful predictor of lung function than smoking.
Highlights
Chronic obstructive pulmonary disease (COPD) represents a major public health problem in developing countries and especially in North Africa [1]
The comparison of the few Tunisian COPD prevalence estimates with the international literature showed that estimated prevalence of COPD in Tunisia was low compared with America and Europe and the disease is certainly under diagnosed [1]
In this paper we report the population estimate of COPD prevalence in Sousse, Tunisia, using the Burden of Obstructive Lung Disease (BOLD) protocol
Summary
Chronic obstructive pulmonary disease (COPD) represents a major public health problem in developing countries and especially in North Africa [1]. It is characterized by lung function impairment with airway obstruction, and is currently estimated to be one of the leading causes of death in 2010 [2]. COPD is one of the leading causes of mortality and morbidity, epidemiological data on COPD are very limited in North Africa, including Tunisia. National estimates of COPD prevalence are usually based on self-reported diagnosis without the use of objective measurement of lung function by spirometry testing. One survey of chronic bronchitis has estimated the prevalence as 3.8%
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