Prevalence of obstructive lung disease in an African country using definitions from different international guidelines: a community based cross-sectional survey.

Eric Walter Pefura-Yone,Charles Lebon Mbele-Onana,Elvira Christelle Kenmegne-Noumsi,Emilienne Régine Ebouki,Christopher Kuaban,Boris Judicaël Theubo-Kamgang,Nelly Rachel Efe-De-Melingui,André Pascal Kengne,Patricia Ingrid Ndjeutcheu-Moualeu,Chrystelle Karen Djuikam-Kamga,Christiane Gaelle Magne-Fotso,Martine Ngo-Yonga,Adamou Dodo Balkissou,Liliane Mboumtou,Elsie Linda Petchou-Talla,Francine Amougou,Julie Raïcha Boulleys-Nana,Barbara Linda Kolontchang-Yomi

doi:10.1186/s13104-015-1731-6

Abstract

BackgroundObstructive lung disease (OLD), a major global public health problem, has been less investigated in African countries. We assessed the prevalence and determinants of OLD in Yaounde (the capital city of Cameroon), using internationally agreed definitions.MethodsParticipants were adults (age >19 years) screened during a community-based survey between December 2013 and April 2014. Air flow limitation (AFL) was based on a pre-bronchodilator forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) below the lower limit of normal (LLN, AFL–LLN). Chronic obstructive pulmonary disease (COPD) was based on post-bronchodilator FEV1/FVC ratio < LLN (COPD–LLN).ResultsOf the 1287 subjects included, 51.9 % were female, 9.3 % were current smokers and their mean age was 34.4 ± 12.8 years. Forty-nine (3.8 %, 95 % CI 2.8–4.9 %) participants had AFL–LLN. Thirty-one subjects had COPD–LLN; giving a prevalence of COPD–LLN of (2.4 %, 95 % CI 1.6–3.3 %). In multivariable analysis, male gender (AOR 2.42; 95 % CI 1.12–5.20) and lifetime wheezing (AOR 2.88; 95 % CI 1.06–7.81) were the determinants of COPD-LLN. Otherwise, male sex (AOR 1.93, 95 % CI 1.00–3.73), age 40–59 years (AOR 1.99, 95 % CI 1.04–3.81) and lifetime wheezing (AOR 2.65, 95 % CI 1.13–6.20) remained as independent determinants of AFL–LLN.ConclusionsObstructive lung disease based on more accurate definitions was relatively infrequent in this population. It is important to sensitize the medical staff and the general public about this condition which should be actively investigated in individuals aged 40 years and above.

Highlights

Obstructive lung disease (OLD), a major global public health problem, has been less investigated in African countries
A striking issue with Chronic obstructive pulmonary disease (COPD) is that the condition is often underestimated by the patient, and largely under diagnosed and as a consequence undertreated by medical doctors [2]
Study population A total of 1612 participants were invited to take part in the study, of whom 57 declined, and a further 56 participants were excluded for a contraindication to spirometry or incomplete questionnaires

Summary

Introduction

Obstructive lung disease (OLD), a major global public health problem, has been less investigated in African countries. Chronic obstructive pulmonary disease (COPD) is a major global public health problem. Smoking is the leading risk factor for COPD worldwide with the attributable risk fraction of COPD from active smoking ranging from 40 to 70 % across countries [4,5,6]. With an estimated prevalence of smoking ranging from 8 to 43 % in men and 5 to 30 % in women, and the expanding tobacco industry across the continent, COPD is set to become a major health challenge in African countries, alongside other communicable and non-communicable diseases [7]. Other contributing factors to the global burden of COPD include age greater than 40 years, air pollution, exposure to biomass, exposure to certain gases, low socioeconomic status, genetic factors, history of pulmonary tuberculosis and HIV infection [4, 8]

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Discussion

Conclusion