Characteristics and phenotypes of a COPD cohort from referral hospital clinics in Uganda
Alupo, Patricia, Mugenyi, Levicatus, Katagira, Winceslaus, Kayongo, Alex, Nalunjogi, Joanitah, Siddharthan, Trishul, Hurst, John R, Kirenga, Bruce and Jones, Rupert C. (2024) Characteristics and phenotypes of a COPD cohort from referral hospital clinics in Uganda. BMJ Open Respiratory Research, 11 (1). ISSN 2052-4439
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Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition with varied clinical and pathophysiological characteristics. Although there is increasing evidence that COPD in low-income and middle-income countries may have different clinical characteristics from that in high-income countries, little is known about COPD phenotypes in these settings. We describe the clinical characteristics and risk factor profile of a COPD population in Uganda. Methods: We cross sectionally analysed the baseline clinical characteristics of 323 patients with COPD aged 30 years and above who were attending 2 national referral outpatient facilities in Kampala, Uganda between July 2019 and March 2021. Logistic regression was used to determine factors associated with spirometric disease severity. Results: The median age was 62 years; 51.1% females; 93.5% scored COPD Assessment Test >10; 63.8% modified medical research council (mMRC) >2; 71.8% had wheezing; 16.7% HIV positive; 20.4% had a history of pulmonary tuberculosis (TB); 50% with blood eosinophilic count >3%, 51.7% had 3 or more exacerbations in the past year. Greater severity by Global initiative for Chronic Obstructive Lung Disease (GOLD) stage was inversely related to age (aOR=0.95, 95% CI 0.92 to 0.97), and obesity compared with underweight (aOR=0.25, 95% CI 0.07 to 0.82). Regarding clinical factors, more severe airflow obstruction was associated with SPO2 <93% (aOR=3.79, 95% CI 2.05 to 7.00), mMRC ≥2 (aOR=2.21, 95% CI 1.08 to 4.53), and a history of severe exacerbations (aOR=2.64, 95% CI 1.32 to 5.26). Conclusion: Patients with COPD in this population had specific characteristics and risk factor profiles including HIV and TB meriting tailored preventative approaches. Further studies are needed to better understand the pathophysiological mechanisms at play and the therapeutic implications of these findings.
| Item Type: | Article |
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| Additional Information: | ** Embargo end date: 15-03-2024 ** From BMJ via Jisc Publications Router ** History: received 08-05-2023; accepted 09-02-2024; ppub 03-2024; epub 15-03-2024. ** Licence for this article starting on 15-03-2024: http://creativecommons.org/licenses/by-nc/4.0/ ** Peer reviewed: TRUE ** Acknowledgements: Dr Jalia Nanyonga who led the clinic team that participated in the study. Rogers Sekibira who helped with the data management. The patients that participated in this COPD study. |
| Keywords: | COPD exacerbations, COPD epidemiology, COPD pathology |
| SWORD Depositor: | JISCRouter |
| Depositing User: | JISCRouter |
| Date Deposited: | 01 May 2024 08:59 |
| Last Modified: | 02 May 2024 03:50 |
| URI: | https://marjon.repository.guildhe.ac.uk/id/eprint/17813 |
| Related URLs: |
https://pubmed. ... h.gov/38490695/
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