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Ale BM, Ozoh OB, Gadanya MA, Li Y, Harhay MO, Adebiyi AO, Adeloye D. Estimating the prevalence of COPD in an African country: evidence from southern Nigeria. JOURNAL OF GLOBAL HEALTH REPORTS 2022; 6:e2022049. [PMID: 36185970 PMCID: PMC9521051 DOI: 10.29392/001c.38200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
# BACKGROUND Though several environmental and demographic factors would suggest a high burden of chronic obstructive pulmonary disease (COPD) in most African countries, there is insufficient country-level synthesis to guide public health policy. # METHODS A systematic search of MEDLINE, EMBASE, Global Health and African Journals Online identified studies reporting the prevalence of COPD in Nigeria. We provided a detailed synthesis of study characteristics, and overall median and interquartile range (IQR) of COPD prevalence in Nigeria by case definitions (spirometry or non-spirometry). # RESULTS Of 187 potential studies, eight studies (6 spirometry and 2 non-spirometry) including 4,234 Nigerians met the criteria. From spirometry assessment, which is relatively internally consistent, the median prevalence of COPD in Nigeria was 9.2% (interquartile range, IQR: 7.6-10.0), compared to a lower prevalence (5.1%, IQR: 2.2-15.4) from studies based on British Medical Research Council (BMRC) criteria or doctor's diagnosis. The median prevalence of COPD was almost the same among rural (9.5%, IQR: 7.6-10.3) and urban dwellers (9.0%, IQR: 5.3-9.3) from spirometry studies. # CONCLUSIONS A limited number of studies on COPD introduces imprecision in prevalence estimates and presents concerns on the level of response available across different parts of Nigeria, and indeed across many countries in sub-Saharan Africa.
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Affiliation(s)
- Boni M. Ale
- Cardiovascular Research Unit, University of Abuja, and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
- Holo Healthcare Limited, Nairobi, Kenya
| | - Obianuju B. Ozoh
- Department of Medicine, College of Medicine, The University of Lagos and The Lagos University Teaching Hospital, Lagos, Nigeria
| | | | - Yiyang Li
- Department of Statistics, University of Warwick, Warwick, UK
| | - Michael O. Harhay
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Davies Adeloye
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
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Njoroge MW, Mjojo P, Chirwa C, Rylance S, Nightingale R, Gordon SB, Mortimer K, Burney P, Balmes J, Rylance J, Obasi A, Niessen LW, Devereux G. Changing lung function and associated health-related quality-of-life: A five-year cohort study of Malawian adults. EClinicalMedicine 2021; 41:101166. [PMID: 34712931 PMCID: PMC8529201 DOI: 10.1016/j.eclinm.2021.101166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In Sub-Saharan Africa cross-sectional studies report a high prevalence of abnormal lung function indicative of chronic respiratory disease. The natural history and health impact of this abnormal lung function in low-and middle-income countries is largely unknown. METHODS A cohort of 1481 adults representative of rural Chikwawa in Malawi were recruited in 2014 and followed-up in 2019. Respiratory symptoms and health-related quality of life (HRQoL) were quantified. Lung function was measured by spirometry. FINDINGS 1232 (83%) adults participated; spirometry was available for 1082 (73%). Mean (SD) age 49.5 (17.0) years, 278(23%) had ever smoked, and 724 (59%) were women. Forced expiratory volume in one second (FEV1) declined by 53.4 ml/year (95% CI: 49.0, 57.8) and forced vital capacity (FVC) by 45.2 ml/year (95% CI: 39.2, 50.5) . Chronic airflow obstruction increased from 9.5% (7.6, 11.6%) in 2014 to 17.5% (15.3, 19.9%) in 2019. There was no change in diagnosed asthma or in spirometry consistent with asthma or restriction. Rate of FEV1 decline was not associated with diagnosed Chronic obstructive pulmonary disease (COPD), asthma, or spirometry consistent with asthma, COPD, or restriction. HRQoL was adversely associated with respiratory symptoms (dyspnoea, wheeze, cough), previous tuberculosis, declining FEV1 and spirometry consistent with asthma or restriction. These differences exceeded the minimally important difference. INTERPRETATION In this cohort, the increasing prevalence of COPD is associated with the high rate of FEV1 decline and lung function deficits present before recruitment. Respiratory symptoms and sub-optimal lung function are independently associated with reduced HRQoL.
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Affiliation(s)
- Martin W. Njoroge
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
- Malawi Liverpool Wellcome Trust Programme, Blantyre, Malawi
- Corresponding author at: Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
| | - Patrick Mjojo
- Malawi Liverpool Wellcome Trust Programme, Blantyre, Malawi
| | | | - Sarah Rylance
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
- Malawi Liverpool Wellcome Trust Programme, Blantyre, Malawi
| | - Rebecca Nightingale
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Stephen B. Gordon
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
- Malawi Liverpool Wellcome Trust Programme, Blantyre, Malawi
| | - Kevin Mortimer
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
- Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
| | - Peter Burney
- National Heart and Lung Institute, Imperial College, London, UK
| | - John Balmes
- University of California, San Francisco, United States of America
- University of California, Berkeley, United States of America
| | - Jamie Rylance
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
- Malawi Liverpool Wellcome Trust Programme, Blantyre, Malawi
| | - Angela Obasi
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Louis W. Niessen
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
- John Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - Graham Devereux
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
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Impact of post-tuberculosis lung disease on health-related quality of life in patients from two tertiary hospitals in Lagos, Nigeria. Afr J Thorac Crit Care Med 2021; 27. [PMID: 34430871 PMCID: PMC8327683 DOI: 10.7196/ajtccm.2021.v27i2.135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 12/20/2022] Open
Abstract
Background
Post-tuberculosis (TB) lung disease is a recognised cause of chronic respiratory disease, and its impact on health-related quality
of life (HRQoL) has not been extensively described.
Objectives
To describe the clinical profile, spirometry impairment and impact of post-TB lung disease on HRQoL among patients attending
two tertiary hospitals in Lagos, Nigeria.
Methods
We conducted a cross-sectional study and obtained data through interviews, chart reviews and physical examination. We measured
dyspnoea severity using the Medical Research Council (MRC) scale, HRQoL with the St George’s respiratory questionnaire (SGRQ) and
performed spirometry. Univariate regression was used to explore the associations between selected variables and HRQoL.
Results
A total of 59 participants were recruited and their median (interquartile range (IQR)) age was 45 (36 - 60) years. The most frequent
symptom was cough (93.2%; n=55) and sputum production (91.5%; n=54). Less than two-thirds of the participants (62.4%; n=38) had
received treatment for TB on more than one occasion, 50.8% (n=30) had moderate to very severe dyspnoea on the MRC scale and 88.7%
(n=47/53) had abnormal spirometry with the mixed pattern predominating in 56.6% (n=30) of the participants. The mean (standard
deviation (SD)) SGRQ component score for symptoms was 43.89 (18.66), followed by activity (42.50 (22.68)), impact (29.41 (17.82)) and
total components (35.78 (17.25)). Dyspnoea, cough, sputum production and weight loss were associated with worsened HRQoL.
Conclusion
Post-TB lung disease was characterised by a high symptom burden, severe spirometry impairment and poor HRQoL. There is
a need for increased recognition and development of guidelines for diagnosis and treatment of post-TB lung disease and for further studies
to explore preventive strategies.
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The Effect of Treatment during A Haze/Post-Haze Year on Subsequent Respiratory Morbidity Status among Successful Treatment Tuberculosis Cases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234669. [PMID: 31771136 PMCID: PMC6926855 DOI: 10.3390/ijerph16234669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate the respiratory morbidity status within the two to three years among successful (completed/cured) treatment of tuberculosis cases during a haze year (2015) and a post-haze year (2016). The study was conducted among 133 cases of a 2015 group and 103 cases of a 2016 group between January to March 2018 in Pekanbaru city, Indonesia. The St George Respiratory Questionnaire (SGRQ) was used to assess respiratory morbidity status. A higher score corresponds to worse respiratory morbidity. Based on a directed acyclic graph, quantile regression models were constructed to assess the associations between haze/post-haze year and the SGRQ (symptom, activity, impact, and total) domains score. The subsequent respiratory morbidity status of tuberculosis (TB) cases was poorer among respondents treated during a haze year (2015). Among SGRQ domains, only the activity domain score showed significant difference, in which the median for the 2015 group was 23.7 (inter-quartile range (IQR); 17.2, 30.9) compared to 18.4 (IQR; 11.9, 24.8) for the 2016 group. The effect was limited to the 2015 group who were exposed by an average PM10 index ≥ 55 during TB treatment. This raises concern for monitoring and improving the quality of life of TB patients treated during a haze year.
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Arslan M, Soylu M, Kaner G, İnanç N, Başmısırlı E. Evaluation of malnutrition detected with the Nutritional Risk Screening 2002 (NRS-2002) and the quality of life in hospitalized patients with chronic obstructive pulmonary disease. Hippokratia 2016; 20:147-152. [PMID: 28416912 PMCID: PMC5388516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Patients with severe chronic obstructive pulmonary disease (COPD) have impaired quality of life, but the relationship between their nutritional status and quality of life has not been established. The aim of this study was to determine the relationship between quality of life and nutritional status in hospitalized COPD patients. METHODS Demographic data, quality of life and nutritional status of 90 inpatients with a mean age of 68.76 ± 10.85 years were enrolled in the study. The Nutritional Risk Screening 2002 (NRS-2002) tool was used to evaluate their nutritional status. The quality of life was assessed using the Short Form-36 (SF-36) questionnaire. The correlation analysis was used for the relationship between SF-36 subscales and nutritional status variables. RESULTS Of the 90 COPD patients included in the study, 54.4 % were men, and 45.6 % were women. Moderate, severe, and very severe COPD were detected in 37.8 %, 38.9 %, and 23.3 % of the patients, respectively. At risk of malnutrition were 55.6 % of the 90 COPD patients, whereas 44.4 % were not. The scores for physical function, physical role functioning, pain, general health, emotional role functioning, vitality, social function, and mental function subscales were lower in the patients at risk of malnutrition (p <0.001). There was a statistically significant negative correlation between malnutrition score and the subscores of SF-36 related to physical function, physical role functioning, pain, general health, emotional role functioning, vitality, social function, and mental function (p <0.001). CONCLUSIONS COPD patients were found to have a high risk of malnutrition that adversely affects their quality of life. Therefore, the evaluation of the nutritional status of COPD patients should be an integral part of their clinical treatment plans aiming towards improving their quality of life. Hippokratia 2016, 20(2):147-152.
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Affiliation(s)
- M Arslan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Hacettepe, Ankara, Turkey
| | - M Soylu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Nuh Naci Yazgan, Kayseri, Turkey
| | - G Kaner
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Izmir Katip Çelebi, Izmir, Turkey
| | - N İnanç
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Nuh Naci Yazgan, Kayseri, Turkey
| | - E Başmısırlı
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Nuh Naci Yazgan, Kayseri, Turkey
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