Prevalence of COPD and its risk factors in a rural area of Uganda

Introduction: In sub-Saharan Africa, little is known about the damage to respiratory health caused by indoor biomass fuel use and tobacco smoke. Aim: To survey the prevalence and burden of COPD and its risk factors in a predominantly rural district of Uganda. Methods: Population-based cross-sectional epidemiological survey of 578 randomly selected adults above the age of 30. Trained local healthcare workers used validated screening and air pollution questionnaires, and performed pre- and postbronchodilator spirometry in the villages. Results: The mean age was 45.3 ± 13.7 and 50.5% of the participants were female. Over 90% were exposed to indoor biomass smoke (particularly wood): 5.2 hours/day in females and 3.1 hours/day in males. 34.4% of the males and 7.4% of the females were current-smokers; 85% of the females never smoked. Using the forced expiratory ratio (FER)< 0.7, the prevalence of COPD was 12.5% (43.8% female); from these, 17.1% of males and 25% of females were in the age group 30-39 years. Using the lower limits of normal (LLN), the prevalence of COPD was 16.2% (52.6% female); from these 35.6% of males and 50% of females were in the age group 30-39 years. Conclusion: The prevalence of COPD in Uganda is high, particularly among young female subjects. Using LLN more younger subjects are diagnosed compared to FER < 0.7. COPD represents a major threat to health for peoples of all ages in rural Uganda. Further analyses will examine the interaction of tobacco smoke, biomass fuel use and other factors in the development of COPD, with the aim to reduce the future risks.