University of Groningen, University Medical Centre Groningen, Harlingen, Netherlands.
Makerere University, Mulago Hospital, Kampala, Uganda.
Lancet Glob Health. 2015 Jan;3(1):e44-51. doi: 10.1016/S2214-109X(14)70337-7.
In sub-Saharan Africa, little is known about the damage to respiratory health caused by biomass smoke and tobacco smoke. We assessed the prevalence of chronic obstructive pulmonary disease (COPD) and related risk factors in a rural region of Uganda.
We did this prospective observational cross-sectional study in rural Masindi, Uganda. We randomly selected people above the age of 30 years from 30 villages. Trained local health-care workers asked validated questionnaires and administered spirometry to participants. We defined COPD as FEV1:FVC less than the lower limit of normal. We calculated prevalence of COPD and tested its association with risk factors.
Between April 13, and Aug 14, 2012, we invited 620 people to participate, of whom 588 provided acceptable spirometry and were analysed. Mean age was 45 years (SD 13·7); 297 (51%) were women. 546 (93%) were exposed to biomass smoke. The prevalence of COPD was 16·2% (15·4% in men, 16·8% in women). Prevalence was highest in people aged 30-39 years (17 [38%] of 45 men, 20 [40%] of 50 women). 20 (44%) of 45 men with COPD were current smokers (mean age 40 years, SD 7·5), 11 (24%) were former smokers (mean age 49 years, SD 11·0); four [8%] of 50 women were current smokers (mean age 52 years, SD 18·1), nine (18%) were former smokers (mean age 64 years, SD 16·2). Mean Clinical COPD Questionnaire score was 0·81 (SD 0·78), mean Medical Research Council dyspnoea score was 1·33 (SD 0·65); 28 (30%) of 95 patients had had one or more exacerbations past 12 months. COPD was associated with wheeze (odds ratio 2·17, 95% CI 1·09-4·34; p=0·028) and being a former smoker (1·96, 1·07-3·59; p=0·029).
In this rural district of Uganda, COPD starts early in life. Major risk factors were biomass smoke for both sexes and tobacco smoke for men. In addition to high smoking prevalence in men, biomass smoke could be a major health threat to men and women in rural areas of Uganda.
International Primary Care Respiratory Group.
在撒哈拉以南非洲地区，人们对生物质烟雾和烟草烟雾对呼吸系统健康造成的损害知之甚少。我们评估了乌干达农村地区慢性阻塞性肺疾病（COPD）的流行情况及其相关危险因素。
我们在乌干达农村的 Masindi 进行了这项前瞻性观察性横断面研究。我们从 30 个村庄中随机选择 30 岁以上的人。经过培训的当地卫生保健工作者向参与者提出了经过验证的问卷并进行了肺活量测定。我们将 COPD 定义为 FEV1:FVC 低于正常下限。我们计算了 COPD 的患病率，并测试了其与危险因素的关联。
在 2012 年 4 月 13 日至 8 月 14 日期间，我们邀请了 620 人参加，其中 588 人提供了可接受的肺活量测定并进行了分析。平均年龄为 45 岁（标准差 13.7）；297 人（51%）暴露于生物质烟雾中。COPD 的患病率为 16.2%（男性为 15.4%，女性为 16.8%）。在 30-39 岁的人群中患病率最高（45 名男性中有 17 名[38%]，50 名女性中有 20 名[40%]）。45 名 COPD 男性中有 20 名（44%）是当前吸烟者（平均年龄为 40 岁，标准差为 7.5），11 名（24%）是前吸烟者（平均年龄为 49 岁，标准差为 11.0）；50 名女性中有 4 名（8%）是当前吸烟者（平均年龄为 52 岁，标准差为 18.1），9 名（18%）是前吸烟者（平均年龄为 64 岁，标准差为 16.2）。平均临床 COPD 问卷评分为 0.81（标准差 0.78），平均医学研究理事会呼吸困难评分为 1.33（标准差 0.65）；95 名患者中有 28 名（30%）在过去 12 个月中有过一次或多次加重。COPD 与喘息（比值比 2.17，95%CI 1.09-4.34；p=0.028）和曾吸烟（1.96，1.07-3.59；p=0.029）有关。
在乌干达这个农村地区，COPD 很早就开始了。主要危险因素是男女两性的生物质烟雾和男性的烟草烟雾。除了男性吸烟率高之外，生物质烟雾可能是乌干达农村地区男女的主要健康威胁。
国际初级保健呼吸组。
Zotero 插件