Department of Medicine, College of Medicine, King Saudi Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey.
Respir Med. 2021 Nov-Dec;189:106641. doi: 10.1016/j.rmed.2021.106641. Epub 2021 Oct 5.
Chronic obstructive pulmonary disease (COPD) has a significant impact on healthcare systems and health-related quality of life. Increased prevalence of smoking is an important factor contributing to high burden of COPD in the Middle East and Africa (MEA). Several other factors including sedentary lifestyle, urbanization, second-hand smoke, air pollution, and occupational exposure are also responsible for the upsurge of COPD in the MEA. Frequent COPD exacerbations accelerate disease progression, progressively deteriorate the lung function, and negatively affect quality of life. This consensus is based on review of the published evidence, international and regional guidelines, and insights provided by the expert committee members from the MEA region. Spirometry, though the gold standard for diagnosis, is often unavailable and/or underutilized leading to underdiagnosis of COPD in primary care settings. Low adherence to the treatment guidelines and delayed use of appropriate combination therapy including triple therapy are additional barriers in management of COPD in MEA. It is necessary to recognize COPD as a screenable condition and develop easy and simple screening tools to facilitate early diagnosis. Knowledge of the disease symptomatology at patient and physician level and adherence to the international or regional guidelines are important to create awareness about harmful effects of smoking and develop national guidelines to focus on prevention on COPD. Implementation of vaccination program and pulmonary rehabilitation are equally valuable to manage patients with COPD at local and regional level. We present recommendations made by the expert panel for improved screening, diagnosis, and management of COPD in MEA.
慢性阻塞性肺疾病（COPD）对医疗体系和健康相关生活质量有重大影响。吸烟率的增加是导致中东和非洲（MEA）COPD负担沉重的重要因素。其他一些因素，包括久坐的生活方式、城市化、二手烟、空气污染和职业暴露，也是 MEA 地区 COPD 发病率上升的原因。频繁的 COPD 加重会加速疾病进展，逐渐恶化肺功能，并对生活质量产生负面影响。本共识基于对已发表证据、国际和区域指南的审查，以及来自 MEA 地区的专家委员会成员提供的见解。肺量测定虽然是诊断的金标准，但往往无法获得和/或未得到充分利用，导致在初级保健环境中 COPD 诊断不足。对治疗指南的低依从性以及延迟使用适当的联合治疗，包括三联疗法，是 MEA 地区 COPD 管理的额外障碍。有必要将 COPD 视为可筛查的疾病，并开发简单易用的筛查工具，以促进早期诊断。在患者和医生层面了解疾病的症状，并遵守国际或区域指南，对于提高对吸烟危害的认识以及制定预防 COPD 的国家指南非常重要。在地方和区域层面，实施疫苗接种计划和肺康复同样有助于管理 COPD 患者。我们提出了专家组关于改善 MEA 地区 COPD 筛查、诊断和管理的建议。
