title: Distribution of COPD-related symptoms in the Middle East and North Africa: results of the BREATHE study.
abstract: 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.
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed Awad
authors.initials: MA
authors.lastname: Tageldin
authors.forename: Salim
authors.initials: S
authors.lastname: Nafti
authors.forename: Javaid Ahmed
authors.initials: JA
authors.lastname: Khan
authors.forename: Chakib
authors.initials: C
authors.lastname: Nejjari
authors.forename: Majed
authors.initials: M
authors.lastname: Beji
authors.forename: Bassam
authors.initials: B
authors.lastname: Mahboub
authors.forename: Nathir M
authors.initials: NM
authors.lastname: Obeidat
authors.forename: Esra
authors.initials: E
authors.lastname: Uzaslan
authors.forename: Abdullah
authors.initials: A
authors.lastname: Sayiner
authors.forename: Siraj
authors.initials: S
authors.lastname: Wali
authors.forename: Nauman
authors.initials: N
authors.lastname: Rashid
authors.forename: Abdelkader
authors.initials: A
authors.lastname: El Hasnaoui
mesh_terms: D000328:Adult; D000352:Africa, Northern / Q000453:epidemiology; D017677:Age Distribution; D000368:Aged; D029481:Bronchitis, Chronic / Q000453:epidemiology / Q000209:etiology; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology*; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology