Burden of Chronic Respiratory Diseases (CRD) in Middle East and North Africa (MENA)

Abdallah, F. Chermiti Ben; Taktak, S.; Chtourou, A.; Mahouachi, R.; Kheder, A. Ben

doi:10.1097/wox.0b013e3182093cbb

Cited by 12 publications

(8 citation statements)

References 11 publications

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“…It is important to note that chronic respiratory disease burden, including asthma has continued to increase in Africa due to lack of appropriate response from the governments of many African countries (81,82). The national emphasis on asthma and relevant health messages have been sub-optimal, leading, in sequence, to poor awareness of the burden, low prioritization, inadequate staffing and resources, and very low budget allocation.…”

Section: Discussionmentioning

confidence: 99%

An estimate of asthma prevalence in Africa: a systematic analysis

Rudan¹,

Chan²,

Rudan³

et al. 2013

Croat Med J

160

167

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AimTo estimate and compare asthma prevalence in Africa in 1990, 2000, and 2010 in order to provide information that will help inform the planning of the public health response to the disease.MethodsWe conducted a systematic search of Medline, EMBASE, and Global Health for studies on asthma published between 1990 and 2012. We included cross-sectional population based studies providing numerical estimates on the prevalence of asthma. We calculated weighted mean prevalence and applied an epidemiological model linking age with the prevalence of asthma. The UN population figures for Africa for 1990, 2000, and 2010 were used to estimate the cases of asthma, each for the respective year.ResultsOur search returned 790 studies. We retained 45 studies that met our selection criteria. In Africa in 1990, we estimated 34.1 million asthma cases (12.1%; 95% confidence interval [CI] 7.2-16.9) among children <15 years, 64.9 million (11.8%; 95% CI 7.9-15.8) among people aged <45 years, and 74.4 million (11.7%; 95% CI 8.2-15.3) in the total population. In 2000, we estimated 41.3 million cases (12.9%; 95% CI 8.7-17.0) among children <15 years, 82.4 million (12.5%; 95% CI 5.9-19.1) among people aged <45 years, and 94.8 million (12.0%; 95% CI 5.0-18.8) in the total population. This increased to 49.7 million (13.9%; 95% CI 9.6-18.3) among children <15 years, 102.9 million (13.8%; 95% CI 6.2-21.4) among people aged <45 years, and 119.3 million (12.8%; 95% CI 8.2-17.1) in the total population in 2010. There were no significant differences between asthma prevalence in studies which ascertained cases by written and video questionnaires. Crude prevalences of asthma were, however, consistently higher among urban than rural dwellers.ConclusionOur findings suggest an increasing prevalence of asthma in Africa over the past two decades. Due to the paucity of data, we believe that the true prevalence of asthma may still be under-estimated. There is a need for national governments in Africa to consider the implications of this increasing disease burden and to investigate the relative importance of underlying risk factors such as rising urbanization and population aging in their policy and health planning responses to this challenge.

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Section: Discussionmentioning

confidence: 99%

An estimate of asthma prevalence in Africa: a systematic analysis

Rudan¹,

Chan²,

Rudan³

et al. 2013

Croat Med J

160

167

View full text Add to dashboard Cite

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“…Chronic obstructive pulmonary disease (COPD) represents a major public health problem in developing countries and especially in North Africa [1]. It is characterized by lung function impairment with airway obstruction, and is currently estimated to be one of the leading causes of death in 2010 [2].…”

Section: Introductionmentioning

confidence: 99%

“…Although COPD is one of the leading causes of mortality and morbidity, epidemiological data on COPD are very limited in North Africa, including Tunisia. The comparison of the few Tunisian COPD prevalence estimates with the international literature showed that estimated prevalence of COPD in Tunisia was low compared with America and Europe and the disease is certainly under diagnosed [1]. In fact, National estimates of COPD prevalence are usually based on self-reported diagnosis without the use of objective measurement of lung function by spirometry testing.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of COPD and Tobacco Smoking in Tunisia — Results from the BOLD Study

Daldoul

Denguezli

Jithoo

et al. 2013

IJERPH

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In Tunisia, there is a paucity of population-based data on Chronic Obstructive Pulmonary Disease (COPD) prevalence. To address this problem, we estimated the prevalence of COPD following the Burden of Lung Disease Initiative. We surveyed 807 adults aged 40+ years and have collected information on respiratory history and symptoms, risk factors for COPD and quality of life. Post-bronchodilator spirometry was performed and COPD and its stages were defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Six hundred and sixty one (661) subjects were included in the final analysis. The prevalence of GOLD Stage I and II or higher COPD were 7.8% and 4.2%, respectively (Lower Limit of Normal modified stage I and II or higher COPD prevalence were 5.3% and 3.8%, respectively). COPD was more common in subjects aged 70+ years and in those with a BMI < 20 kg/m2. Prevalence of stage I+ COPD was 2.3% in <10 pack years smoked and 16.1% in 20+ pack years smoked. Only 3.5% of participants reported doctor-diagnosed COPD. In this Tunisian population, the prevalence of COPD is higher than reported before and higher than self-reported doctor-diagnosed COPD. In subjects with COPD, age is a much more powerful predictor of lung function than smoking.

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“…This has often led to delay in the diagnosis till the disease becomes clinically apparent or is in an advanced stage. [29] There are conflicting data about smoking in the region; however, prevalence of smoking in men varies between 20% in Iran and 63% in Turkey. [30] This was also reflected in a recently released report by the WHO about the global tobacco epidemic that showed prevalence of smoking in the Middle East ranged from 38.5% in Lebanon to 62.0% in Syria.…”

Section: Epidemiologymentioning

confidence: 99%

“…The main risk factors for COPD in the Middle East are considered to be tobacco smoke, passive smoking, and other indoor and outdoor air pollutants. [2229] In this region, COPD affects more people with low socioeconomic status, as smoking is more prevalent among illiterate people. [223334] Environmental factors, such as indoor air pollution from biomass fuel used for cooking and heating, appear to contribute to COPD in women.…”

Section: Epidemiologymentioning

confidence: 99%

The Saudi guidelines for the diagnosis and management of COPD

Khan¹,

Lababidi²,

Al-Moamary³

et al. 2014

Ann Thorac Med

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The Saudi Thoracic Society (STS) launched the Saudi Initiative for Chronic Airway Diseases (SICAD) to develop a guideline for the diagnosis and management of chronic obstructive pulmonary disease (COPD). This guideline is primarily aimed for internists and general practitioners. Though there is scanty epidemiological data related to COPD, the SICAD panel believes that COPD prevalence is increasing in Saudi Arabia due to increasing prevalence of tobacco smoking among men and women. To overcome the issue of underutilization of spirometry for diagnosing COPD, handheld spirometry is recommended to screen individuals at risk for COPD. A unique feature about this guideline is the simplified practical approach to classify COPD into three classes based on the symptoms as per COPD Assessment Test (CAT) and the risk of exacerbations and hospitalization. Those patients with low risk of exacerbation (<2 in the past year) can be classified as either Class I when they have less symptoms (CAT < 10) or Class II when they have more symptoms (CAT ≥ 10). High-risk COPD patients, as manifested with ≥2 exacerbation or hospitalization in the past year irrespective of the baseline symptoms, are classified as Class III. Class I and II patients require bronchodilators for symptom relief, while Class III patients are recommended to use medications that reduce the risks of exacerbations. The guideline recommends screening for co-morbidities and suggests a comprehensive management approach including pulmonary rehabilitation for those with a CAT score ≥10. The article also discusses the diagnosis and management of acute exacerbations in COPD.

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Burden of Chronic Respiratory Diseases (CRD) in Middle East and North Africa (MENA)

Cited by 12 publications

References 11 publications

An estimate of asthma prevalence in Africa: a systematic analysis

An estimate of asthma prevalence in Africa: a systematic analysis

Prevalence of COPD and Tobacco Smoking in Tunisia — Results from the BOLD Study

The Saudi guidelines for the diagnosis and management of COPD

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