- Title
- COPD in Africa: risk factors, hospitalisation, readmission and associated outcomes-a systematic review and meta-analysis
- Creator
- Njoku, Chidiamara Maria; Hurst, John R.; Kinsman, Leigh; Balogun, Saliu; Obamiro, Kehinde
- Relation
- Thorax Vol. 78, Issue 6, p. 596-605
- Publisher Link
- http://dx.doi.org/10.1136/thorax-2022-218675
- Publisher
- BMJ Group
- Resource Type
- journal article
- Date
- 2023
- Description
- Background: This review aims to synthesise available evidence on the prevalence of chronic obstructive pulmonary disease (COPD), associated risk factors, hospitalisations and COPD readmissions in Africa. Method: Using the Met-Analyses and Systematic Reviews of Observational Studies guideline, electronic databases were searched from inception to 1 October 2021. The quality of studies was assessed using the Newcastle-Ottawa Scale. Evidence from retrieved articles was synthesised, and a random-effect model meta-analysis was conducted. The protocol was registered on PROSPERO. Results: Thirty-nine studies met the inclusion criteria, with 13 included in the meta-analysis. The prevalence of COPD varied between the Global Initiative for Chronic Obstructive Lung Disease (2%–24%), American Thoracic Society/European Respiratory Society (1%–17%) and Medical Research Council chronic bronchitis (2%–11%) criteria, respectively. Increasing age, wheezing and asthma were consistent risk factors for COPD from studies included in the narrative synthesis. Our meta-analysis indicated that prior tuberculosis ((OR 5.98, 95% CI 4.18 to 8.56), smoking (OR 2.80, 95% CI: 2.19 to 3.59) and use of biomass fuel (OR 1.52, 95% CI: 1.39 to 1.67)) were significant risk factors for COPD. Long-term oxygen therapy (HR 4.97, 95% CI (1.04 to 23.74)) and frequent hospitalisation (≥3 per year) (HR 11.48, 95% CI (1.31 to 100.79)) were risk factors associated with 30-day COPD readmission. Conclusion: This study not only highlights specific risk factors for COPD risk in Africa but also demonstrates the paucity and absence of research in several countries in a continent with substantial COPD-related mortality. Our findings contribute towards the development of evidence-based clinical guidelines for COPD in Africa.
- Subject
- COPD epidemiology; COPD exacerbations; long term oxygen therapy (LTOT); tuberculosis; SDG 3; SDG 7; SDG 17; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1488916
- Identifier
- uon:52580
- Identifier
- ISSN:0040-6376
- Language
- eng
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