Chronic obstructive pulmonary disease in South Africa: Under-recognised and undertreated

Allwood, Brian; Zyl-Smit, Richard van

doi:10.7196/samjnew.8429

Cited by 2 publications

(2 citation statements)

References 10 publications

(9 reference statements)

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“…WHO estimates that COPD affects almost 329 million people (4.8% of the world's population), however it is under-recognised and undertreated in most populations. 34 Asthma is estimated to affect 334 million people, 4.9% of the world's population. 635 million people are reported to be living with some level of asthma-like symptoms.…”

Section: Copd and Asthma Disease Burdenmentioning

confidence: 99%

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The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa

Ahmed¹,

Robinson

Mortimer

2017

Mal. Med. J

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Noncommunicable diseases (NCDs) are a major and increasing global health issue. The World Health Organization (WHO) estimates that NCDs represent 63% of all global deaths of which 3.9 million are due to chronic respiratory diseases (CRDs) and Chronic Obstructive Pulmonary Disease (COPD) in particular. COPD is now the third most common cause of death globally; 90% of these deaths occur in Low and Middle Income Countries (LMICs). COPD affects 329 million people, almost 5% of the world's population. In addition, asthma affects 334 million people, again representing almost 5% of the world's population. There is limited literature published on the epidemiology of COPD and Asthma from Sub-Saharan Africa (SSA) and Middle East and North Africa (MENA). Both diseases are under-diagnosed and underestimated in both SSA and MENA regions. The burden of COPD in sub-Saharan Africa is disputed and reports offer variable prevalence estimates, ranging from 4.1% to almost 22.2%. SSA and MENA countries report similar mortality rates from COPD of 18 per 100,000 population (2001 data). Asthma is a less common cause of death than COPD but is a major cause of morbidity; WHO estimates that there are 250,000 deaths per year from asthma, mainly in LMICs and it remains in the top twenty causes of disability in children globally. Risk factors for CRD are genetic and environmental; the latter dominated by air pollution exposures including tobacco smoke, household air pollution, outdoor air pollution and occupational exposures.

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Section: Copd and Asthma Disease Burdenmentioning

confidence: 99%

“… 5 However, many areas with high COPD mortality rates have a low consumption of tobacco. 5 , 34 Tobacco alone, therefore, does not fully illuminate the varying prevalence globally, and other factors need to be explored in LMICs. 5 , 42 , 50 , 30 , 71…”

Section: Risk Factors For Crd In Ssa and Menamentioning

confidence: 99%

The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa

Ahmed¹,

Robinson

Mortimer

2017

Mal. Med. J

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Impact of COVID-19 primary healthcare service restrictions on patients with chronic obstructive pulmonary disease in Cape Town, South Africa

et al. 2022

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Background. Patients with chronic obstructive pulmonary disease (COPD) typically experience multidimensional symptoms throughout the course of their disease, with burdensome physical symptoms, social isolation, and additional psychological suffering. COVID-19 lockdown resulted in restrictions on chronic care delivery at primary healthcare (PHC) facilities, and it is not known what the care experiences of patients with COPD were during this time.Objectives. To describe patient experiences of the impact of the lockdown on their needs and their experiences of the primary care received for their COPD.Methods. The data reported in this paper are from a cohort of 49 patients with COPD receiving primary care, recruited in February and March 2020, before recruitment was paused for COVID-19 lockdown, for a feasibility stepped-wedge hybrid type II design randomised controlled trial of integrated person-centred palliative care in primary care for patients with COPD in Cape Town, South Africa. Data are open-text responses from participants who responded to a single question on a validated measure of primary care consultation empathy (CARE), and describe patient experiences of the impact of the lockdown on the primary care received for their COPD, prior to crossover to trial intervention.Results. Thirty-two patients with COPD gave between 1 and 9 responses each to the open-ended question between March and December 2020. The average age of the participants was 58.6 years, and 53.1% (n=17) were female. Inductive analysis of the open-text data identified four main themes. Participants described decreased access to chronic care and a desire for more person-centred care in interactions with healthcare professionals. The socioeconomic ramifications of the COVID-19 lockdown added to the burden they experienced.Conclusion. The COVID-19 lockdown PHC service restrictions caused a disruption to the continuity of care for patients with COPD, with associated worry, anxiety and disappointment. Medication access was largely supported by the home delivery of chronic medication. We suggest that there are opportunities for providing more sustained support for patients with COPD through referrals to community health workers, and also through telephonic patient follow-up by primary care teams

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Chronic obstructive pulmonary disease in South Africa: Under-recognised and undertreated

Cited by 2 publications

References 10 publications

The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa

The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa

Impact of COVID-19 primary healthcare service restrictions on patients with chronic obstructive pulmonary disease in Cape Town, South Africa

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