Ain Shams University, Cairo, Egypt.
Respir Med. 2012 Dec;106 Suppl 2:S25-32. doi: 10.1016/S0954-6111(12)70012-4.
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.
慢性阻塞性肺疾病（COPD）是全球发病率和死亡率的主要原因。然而，许多发展中国家的 COPD 流行病学特征描述不足。本分析的目的是评估在中东和北非（阿尔及利亚、埃及、约旦、黎巴嫩、摩洛哥、沙特阿拉伯、叙利亚、突尼斯、土耳其和阿拉伯联合酋长国）以及巴基斯坦的十个国家的≥40 岁的大量个体中与 COPD 相关的呼吸症状，采用标准化方法。随机联系了 457258 个电话号码。对每个合格的参与者进行了一个筛选问卷，其中包括六个与呼吸症状有关的问题。在 65154 名合格的受试者中，有 62086 人同意参加，61551 人提供了可用数据。调整年龄和性别后，症状（持续性多痰或呼吸困难或两者兼有）的患病率为 14.3%[95%CI：14.0-14.6%]，范围从阿联酋的 7.2%到阿尔及利亚的 19.1%。女性（16.7%）的症状发生率高于男性（12.2%）（p<0.0001）。根据“流行病学”定义（症状或诊断和吸烟≥10 包·年）调整后的 COPD 患病率为 3.6%[95%CI：3.5-3.7%]（范围：阿联酋的 1.9%到叙利亚的 6.1%）。男性（5.2%）的 COPD 患病率高于女性（1.8%）（p<0.0001）。吸烟者（p<0.001）和水烟使用者（p<0.026）的症状频率显著更高。总之，该地区 COPD 的患病率似乎低于工业化国家的报告。漏报和除吸烟以外的其他危险因素可能导致了这一差异。
