Elsevier

Respiratory Medicine

Volume 106, Supplement 2, December 2012, Pages S25-S32
Respiratory Medicine

Distribution of COPD-related symptoms in the Middle East and North Africa: Results of the BREATHE study

https://doi.org/10.1016/S0954-6111(12)70012-4Get rights and content
Under an Elsevier user license
open archive

Summary

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. However, its epidemiology in many developing countries is poorly characterised. The objective of this analysis was to evaluate respiratory symptoms which could be COPD-related in a large sample of individuals aged ⩾40 years in ten countries in the Middle East and North Africa (Algeria, Egypt, Jordan, Lebanon, Morocco, Saudi Arabia, Syria, Tunisia, Turkey and United Arab Emirates), together with Pakistan, using a standardised methodology. A random sample of 457,258 telephone numbers was contacted. A screening questionnaire was administered to each eligible participant, which included six questions relating to respiratory symptoms. Of 65,154 eligible subjects, 62,086 agreed to participate and 61,551 provided usable data. The age- and gender-adjusted prevalence of symptoms (persistent productive cough or breathlessness or both) was 14.3% [95% CI: 14.0–14.6%], ranging from 7.2% in UAE to 19.1% in Algeria. Symptoms were more frequent (p < 0.0001) in women (16.7%) than in men (12.2%). The adjusted prevalence of COPD according to the “epidemiological” definition (symptoms or diagnosis and cigarette use ⩾10 pack·years) was 3.6% [95% CI: 3.5–3.7%] (range: 1.9% in UAE to 6.1% in Syria). COPD was more frequent (p < 0.0001) in men (5.2%) than in women (1.8%). The frequency of symptoms was significantly higher in cigarette smokers (p< 0.001), as well as in waterpipe users (p < 0.026). In conclusion, the prevalence of COPD in this region seems to be lower than that reported in industrialised countries. Under-reporting and risk factors other than smoking may contribute to this difference.

Keywords

COPD
Symptoms
Middle East
North Africa
BREATHE study
Prevalence
Chronic bronchitis
Smoking

Cited by (0)

BREATHE core team members: Abdelkader El Hasnaoui, GlaxoSmithKline, Dubai, UAE; Nauman Rashid, GlaxoSmithKline, Dubai, UAE; Aïcha Lahlou, MS Health, Rabat, Morocco; Adam Doble, Foxymed, Paris, France, Hocine Salhi, Foxymed, Paris, France and Chakib Nejjari Faculty of Medicine of Fez, Fez, Morocco.

Conflict of interest statement

MAT, SN, JAK, MB, BM, NMO, EU, AS and SW have received honoraria from GlaxoSmithKline Laboratories for their contribution to the BREATHE study. CN advised on the data management and statistical analysis of the results of the BREATHE study on behalf of GlaxoSmithKline Laboratories. NR and AEH are employees of GlaxoSmithKline Laboratories, which funded the BREATHE study and market a number of treatments for COPD.

A

All academic authors contributed equally to the work presented.

B

BREATHE Steering Committee members (in alphabetical order of names): Ashraf Alzaabi, Zayed Military Hospital, Abu Dhabi, UAE; Majed Beji, University of Tunis El Manar, Faculty of Medicine of Tunis, La Rabta Hospital, Tunis, Tunisia; Ali Ben Kheder, Abderrahmane Mami Hospital, Tunis, Tunisia; Magdy Idrees, Riyadh Military Hospital, Riyadh, Saudi Arabia; Ghali Iraqui, Moulay Youssef Hospital, Rabat, Morocco; Arshad Javaid, Lady Reading Hospital, Peshawar, Pakistan; Javaid Ahmed Khan, Aga Khan University Hospital, Karachi, Pakistan; Adel Khattab, Ain Shams University, Cairo, Egypt; Marie Louise Koniski, Lebanese American University, Beirut, Lebanon; Bassam Mahboub, University of Sharjah, Sharjah, UAE; Salim Nafti, Mustapha Bacha Hospital, Algiers, Algeria; Nathir M. Obeidat, University of Jordan, Amman, Jordan; Mehmet Polatli, Adnan Menderes University, Aydin, Turkey; Abdullah Sayiner, Ege University, Izmir, Turkey; Naem Shahrour, Alasaad University Hospital, Damascus, Syria; Mohamed Awad Tageldin, Ain Shams University, Cairo, Egypt; Samya Taright, Bab-El-Oued Hospital, Algiers, Algeria; Esra Uzaslan, Uludag University Medical Faculty, Bursa, Turkey; Siraj Wali, King Abdulaziz University, Jeddah, Saudi Arabia.