title: The burden of chronic obstructive pulmonary disease in the Middle East and North Africa: results of the BREATHE study.
abstract: COPD is a progressive pulmonary disease which may have a profound impact on general health status and quality of life. This article presents data on the burden of COPD obtained from the BREATHE study in the Middle East, North Africa and Pakistan. This study was a large general population survey of COPD conducted in eleven countries of the region using a standardised methodology. A total of 62,086 subjects were screened, of whom 2,187 fulfilled the "epidemiological" definition of COPD. Data on symptoms, perceived disease severity, impact on work, limitations in activities and psychological distress were collected. 1,392 subjects were analysable of whom 661 (47.5%) reported experiencing an exacerbation of their respiratory condition, 49.4% reported comorbidities and 5.5% reported severe breathlessness as measured with the MRC breathlessness questionnaire. The degree of breathlessness, as well as the perceived severity, was correlated with the overall disease impact as measured with the COPD Assessment Test (p < 0.001). 374 subjects (28.4%) reported that their respiratory condition prevented them from working and this proportion rose to 47.8% in subjects who perceived their respiratory condition as severe. 47.9% of subjects reported difficulties in normal physical exertion, 37.5% in social activities and 31.7% in family activities. Psychological distress was reported by between 42.3% and 53.2% of subjects, depending on the item. In conclusion, the burden of COPD is important, and covers central aspects of daily life. For this reason, physicians should take time to discuss it with their patients, and ensure that the management strategy proposed addresses all their needs.
authors.affiliation: Uludag University Medical Faculty, Bursa, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Uzaslan
authors.forename: Bassam
authors.initials: B
authors.lastname: Mahboub
authors.forename: Majed
authors.initials: M
authors.lastname: Beji
authors.forename: Chakib
authors.initials: C
authors.lastname: Nejjari
authors.forename: Mohamed Awad
authors.initials: MA
authors.lastname: Tageldin
authors.forename: Javaid Ahmed
authors.initials: JA
authors.lastname: Khan
authors.forename: Salim
authors.initials: S
authors.lastname: Nafti
authors.forename: Nathir M
authors.initials: NM
authors.lastname: Obeidat
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: D000203:Activities of Daily Living; D000328:Adult; D000352:Africa, Northern / Q000453:epidemiology; D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D010154:Pakistan / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D011788:Quality of Life; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D014937:Work / Q000706:statistics & numerical data