Introduction: Chronic obstructive pulmonary disease (COPD) continues to pose a global public health challenge. However, literature is scarce on the burden of COPD in Malawi. We assessed the prevalence and risk factors for COPD among adults in Neno, Malawi.
Methodology: We conducted a population-based analytical cross-sectional study in Neno District between December 2021 and November 2022. Using a multi-stage sampling technique, we included 525 adults aged≥ 40 years. All participants underwent spirometry according to the American Thoracic Society (ATS) guidelines and were interviewed using the IMPALA questionnaire. For this study, we utilized the definition of COPD as a post-bronchodilator FEV1/FVC < 0.70. We collected data using Kobo collect, exported to Microsoft Excel, and analysed using R software. We used descriptive statistics and logistic regression analysis; a p-value of < 0.05 was considered statistically significant.
Results: Out of 525 participants, 510 participants were included in the final analysis. Fifty-eight percent of the participants were females (n=296), and 62.2% (n=317) were between 40 and 49 years with a median (IQR) age of 46 (40– 86). For patient characteristics, 15.1% (n=77) were current smokers, and 4.1% (n=21) had a history of pulmonary tuberculosis (PTB). Cough was the most commonly reported respiratory symptom (n=249, 48.8%). The prevalence of COPD was 10.0% (n=51) and higher (15.0%) among males compared to females (6.4%). Factors significantly associated with COPD were age 60 years and above (adjusted odds ratio [aOR] = 3.27, 95% CI: 1.48– 7.34, p< 0.004), ever smoked (aOR = 6.17, 95% CI:1.89– 18.7, p< 0.002), current smoker (aOR = 17.6, 95% CI: 8.47– 38.4, p< 0.001), and previous PTB (aOR = 4.42, 95% CI: 1.16– 15.5, p< 0.023).
Conclusion: The cross-sectional prevalence of COPD in rural Malawi is high, especially among males. Factors significantly associated were older age (60 years and above), cigarette smoking, and previous PTB. Longitudinal studies are needed to better understand disease etiology and progression in this setting.

Keywords: chronic obstructive pulmonary disease, prevalence, spirometry, associated factors, Malawi


中文翻译：

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马拉维尼诺区成人慢性阻塞性肺疾病的患病率及相关因素：一项横断面分析研究

简介：慢性阻塞性肺疾病（COPD）继续构成全球公共卫生挑战。然而，关于马拉维慢性阻塞性肺病负担的文献很少。我们评估了马拉维尼诺成人慢性阻塞性肺病的患病率和危险因素。
方法：我们于 2021 年 12 月至 2022 年 11 月期间在尼诺区进行了一项基于人群的分析横断面研究。我们采用多阶段抽样技术，纳入了 525 名年龄≥ 40 岁的成年人。所有参与者均根据美国胸科学会 (ATS) 指南进行了肺活量测定，并使用 IMPALA 问卷进行了访谈。在本研究中，我们将 COPD 定义为支气管扩张剂后 FEV1/FVC < 0.70。我们使用 Kobo Collect 收集数据，导出到 Microsoft Excel，并使用 R 软件进行分析。我们使用描述性统计和逻辑回归分析； p 值 < 0.05 被认为具有统计显着性。
结果： 525名参与者中，510名参与者进入最终分析。 58% 的参与者为女性 (n=296)，62.2% (n=317) 年龄在 40 至 49 岁之间，中位 (IQR) 年龄为 46 (40-86)。就患者特征而言，15.1% (n=77) 是当前吸烟者，4.1% (n=21) 有肺结核 (PTB) 病史。咳嗽是最常见的呼吸道症状（n=249，48.8%）。男性慢性阻塞性肺病的患病率为 10.0% (n=51)，男性的患病率为 15.0%，而女性的患病率为 6.4%。与 COPD 显着相关的因素包括年龄 60 岁及以上（调整后比值比 [aOR] = 3.27，95% CI：1.48–7.34，p < 0.004）、曾经吸烟（aOR = 6.17，95% CI：1.89–18.7，p < 0.002）、当前吸烟者（aOR = 17.6，95% CI：8.47–38.4，p< 0.001）和既往 PTB（aOR = 4.42，95% CI：1.16–15.5，p< 0.023）。
结论：马拉维农村地区慢性阻塞性肺病的横断面患病率很高，尤其是男性。显着相关的因素包括年龄较大（60 岁及以上）、吸烟和既往 PTB。需要进行纵向研究以更好地了解这种情况下的疾病病因和进展。

关键词：慢性阻塞性肺疾病、患病率、肺活量测定、相关因素、马拉维