Predictors of chronic bronchitis in South African adults.
METHODS
National household survey of adults in South Africa, a middle income country.


OBJECTIVE
To determine the prevalence and predictors of chronic bronchitis.


METHODS
A stratified national probability sample of households was selected. All adults in the selected households were interviewed. Chronic bronchitis was defined as chronic productive cough. Socio-demographic predictors were wealth, education, race, age and urban residence. Personal and exposure variables included history of tuberculosis, domestic exposure to smoky fuels, occupational exposures, smoking and body mass index.


RESULTS
The overall prevalence of chronic bronchitis was 2.3% in men and 2.8% in women. The strongest predictor of chronic bronchitis was a history of tuberculosis (men, odds ratio [OR] 4.9; 95% confidence interval [CI] 2.6-9.2; women, OR 6.6; 95%CI 3.7-11.9). Other risk factors were smoking, occupational exposure (in men), domestic exposure to smoky fuel (in women) and (in univariate analysis only) being underweight. Wealth and particularly education were protective.


CONCLUSIONS
The pattern of chronic bronchitis in South Africa suggests a combination of risk factors that includes not only smoking but also tuberculosis, occupational exposures in men and domestic fuel exposure in women. Control of these risk factors requires public health action across a broad front. The protective role of education requires elucidation.
Ehrlich
R I
RI
School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. ehrlich@cormack.uct.ac.za
White
N
N
Norman
R
R
Laubscher
R
R
Steyn
K
K
Lombard
C
C
Bradshaw
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D029481:Bronchitis, Chronic / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005648:Fuel Oils / Q000009:adverse effects; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D010366:Peak Expiratory Flow Rate; D015995:Prevalence; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology
D005648:Fuel Oils; D012906:Smoke