PROFILE AND RISK FACTORS OF PATIENTS WITH OBSTRUCTIVE AIRWAY DISEASES AT TIKUR ANBESSA SPECIALIZED HOSPITAL CHEST CLINIC, ADDIS ABABA, ETHIOPIA
Background: Obstructive airway diseases are major causes of morbidity and mortality worldwide. There is are limited published data in Ethiopia.The purpose of this study was to characterize and identify the risk factors of patients with obstructive airway diseases.Methods: A retrospective, cross-sectional review of patients seen at TASH chest clinic, between January 2013-December 2013 and all adult patients with a physician diagnosis of obstructive airway diseases were identified and their demographic and clinical data were included in the analysis.Results: During the study period, there were 144 patients seen with a clinical diagnosis of obstructive airway disease.Fifty six percent were females and 74.6% were from Addis Ababa. The mean age was 52.8±13.8 years.Among the participants, 26% and 27% had history of prior tuberculosis treatment, and prior pneumonia, respectively. Approximately 17% had ever smoked cigarettes, which was exclusively among men. Among patients who reported symptoms, 73%, 83%, and 75% presented with cough, wheezing and dyspnea respectively. Asthma was the primary diagnosis among 86% of patients; the remainder carried a diagnosis of chronic obstructive pulmonary disease (COPD). Among those who had spirometry, 55.8% of asthmatics and 63.6 % of COPD had an obstructive ventilatory defect (FEV1/FVC ratio of less than 0.7). Among COPD patients, 40% were ever smokers, and 40% were females.Conclusions: The majority are female, non-smoking and asthmatics.Future study will incorporate bronchodilator testing.
Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 2001; 163: 1256-76.
Global strategy for asthma management and prevention, global initiative for asthma (GINA)2015 www.ginasthma.org.
Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet 2007; 370: 765-73
Eder W, Ege MJ. Von Mutius E: The asthma epidemic N Engl J Med 2006;355:2226-35
Burr ML. is asthma increasing ? J Epidemiol community health 1987;41:185-9
Lopez AD, Shibuya K, Rao C, et al. chronic obstructive pulmonary disease, current burden and future Projections. Eur Respir J 2006;27:397-412
Buist AS , McBurnie MA , Vollmer WM , et al ; BOLD Collaborative Research Group. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007; 370 (9589): 741 - 50.
Zhou Y , Wang C , Yao W , et al . COPD in Chinese nonsmokers. Eur Respir J . 2009 ; 33( 3 ): 509-18
Smith KR . Inaugural article: national burden of disease in India from indoor air pollution . Proc Natl Acad Sci U S A . 2000 ; 97 ( 24 ): 13286 - 93
Ezzati M . Indoor air pollution and health in developing countries . Lancet . 2005 ; 366( 9480 ): 104-6.
Oroczo-Levi M, Garcia-Aymerich J, Villar J, Ramírez-Sarmiento A, Antó JM , Gea J . Wood smoke exposure and risk of chronic obstructive pulmonary disease . Eur Respir J . 2006 ; 27( 3 ): 542 -6 .
Graciela E, Duane L, Stefano G, Robert A. Asthma as a risk factor for COPD in a longitudinal study. Chest 2004;126:59-65
Ait Khaled N, Enarson D, Bousquet J. chronic respiratory diseases in developing countries ,the burden and strategies for prevention and management .Bull world Health org 2011;79:971-9
Tefera A,and Abdul Kadir J. Analysis of medical admissions to the Princess Tsehai memorial hospital from april 1966 to march 1967.eth.med .J.1968;95-102
Lester FT and Tsega E. The pattern of adult medical admissions in Addis Ababa, Ethiopia. East African medical Journal.1976;53(11):620-34
Yemanebirhan H, Bekele Z, Venn A et al. Prevalence of wheeze and asthma and relation to atopy in urban and rural Ethiopia. Lancet,1997;350:85-90
K Melaku, Y Birhane. prevalence of wheeze and asthma –related symptoms among school children of Addis Ababa. Ethiop Med J 1999;37(4):247-54
Seyoum B, Amara J. bronchial asthma in Jimma: A prospective analysis of 204 patients. Ethiop Med J 1992;30:225-32.
Romain AP, Klaus F. Burden and clinical features of COPD. Lancet 2004;364:613-20
Willcox PA, Ferguson AD. Chronic obstructive airways disease following treated pulmonary tuberculosis. Respir Med 1989; 83: 195-8.
Martins P, Josado-Pinto J, Do Ceu Teixeira M, et al .Under repot and under diagnosing of chronic respiratory disease in African Countries. allergy 2009;64:1061-7