Prevalence of chronic respiratory disease in urban and rural Uganda

Trishul Siddharthan, Matthew Grigsby, Brooks Morgan, Robert Kalyesubula, Robert A Wise, Bruce Kirenga, William Checkley, Trishul Siddharthan, Matthew Grigsby, Brooks Morgan, Robert Kalyesubula, Robert A Wise, Bruce Kirenga, William Checkley

Abstract

Objective: To determine the prevalence of chronic respiratory diseases in urban and rural Uganda and to identify risk factors for these diseases.

Methods: The population-based, cross-sectional study included adults aged 35 years or older. All participants were evaluated by spirometry according to standard guidelines and completed questionnaires on respiratory symptoms, functional status and demographic characteristics. The presence of four chronic respiratory conditions was monitored: chronic obstructive pulmonary disease (COPD), asthma, chronic bronchitis and a restrictive spirometry pattern.

Findings: In total, 1502 participants (average age: 46.9 years) had acceptable, reproducible spirometry results: 837 (56%) in rural Nakaseke and 665 (44%) in urban Kampala. Overall, 46.5% (698/1502) were male. The age-adjusted prevalence of any chronic respiratory condition was 20.2%. The age-adjusted prevalence of COPD was significantly greater in rural than urban participants (6.1 versus 1.5%, respectively; P < 0.001), whereas asthma was significantly more prevalent in urban participants: 9.7% versus 4.4% in rural participants (P < 0.001). The age-adjusted prevalence of chronic bronchitis was similar in rural and urban participants (3.5 versus 2.2%, respectively; P = 0.62), as was that of a restrictive spirometry pattern (10.9 versus 9.4%; P = 0.82). For COPD, the population attributable risk was 51.5% for rural residence, 19.5% for tobacco smoking, 16.0% for a body mass index < 18.5 kg/m2 and 13.0% for a history of treatment for pulmonary tuberculosis.

Conclusion: The prevalence of chronic respiratory disease was high in both rural and urban Uganda. Place of residence was the most important risk factor for COPD and asthma.

Figures

Fig. 1
Fig. 1
Kampala (urban) and Nakaseke (rural) enumeration areas, study of chronic respiratory disease, Uganda, 2015–2016
Fig. 2
Fig. 2
Crude and age- and sex-adjusted prevalence of chronic respiratory disease in rural and urban Uganda, 2015–2016
Fig. 3
Fig. 3
Risk factors for chronic respiratory conditions, Uganda, 2015–2016
Fig. 4
Fig. 4
Lung function, by sex and place of residence, Uganda, 2015–2016
Fig. 5
Fig. 5
Estimated effect of sociodemographic and clinical variables on lung function, Uganda, 2015–2016

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