Prevalence and impact of chronic obstructive pulmonary disease in a rural district of Uganda:FRESH AIR methodology for sub-Saharan Africa

Prevalence and impact of chronic obstructive pulmonary disease in a rural district of Uganda: FRESH AIR methodology for sub-Saharan AfricaWorldwide, tobacco smoking is the most common encountered risk factor for chronic obstructive pulmonary disease (COPD). However, in many low and middle-income countries, household air pollution due to biomass fuel use for domestic cooking and heating is another important risk factor for the development of COPD. Unfortunately, most people in sub-Saharan Africa are unaware of the health damaging effects of biomass smoke. In the rural district of Masindi in Uganda, the word ‘COPD’ is entirely unknown. The general lack of knowledge on COPD has created different beliefs and attitudes towards respiratory symptoms. Furthermore, the majority of the communities cooks indoors using wood in an open fire without any ventilation. In addition, many (young) men smoke tobacco.We performed a, by World Health Organization recommended, observational study in 600 randomly selected participants above the age of 30 years in Masindi district, helped by well-trained local healthcare workers. The study shows a prevalence of spirometry-based COPD of 16.2%; 39% of adults with COPD are aged between 30-39 years, meaning that COPD strikes the population much earlier than in developed countries. There is growing evidence that the detrimental effects of biomass smoke start in early childhood.The study shows an urgent need for reducing tobacco smoking and exposure to biomass smoke by clean cooking solutions for the communities. Prevention and intervention programmes must involve everybody and start as early as possible