The prevalence of COPD in Annaba, Algeria: Results of the BOLD study

Introduction: Chronic obstructive pulmonary disease (COPD) is an increasing health concern worldwide, particularly in developing countries which are experiencing an epidemiological and demographic transition, and where the burden of COPD is largely unknown. Objective: To assess the prevalence of spirometrically confirmed COPD in Annaba (Algeria). Method: We conducted a cross-sectional spirometric survey on a representative sample of adults of 40 years or more using the Burden Obstructive Lung Disease (BOLD) protocol. We collected information on exposure to risk factors, respiratory symptoms and medical history. Pre and post-bronchodilator spirometry were performed and quality controlled for inclusion in analyses. A post-bronchodilator FEV1/FVC below the lower limit of normal was defined as COPD. The severity of bronchial obstruction was further defined by post-bronchodilator FEV1 Results: Among 917 participants, 97% performed acceptable post-bronchodilator spirometry that met the ERS/ATS criteria and 61% were never smokers. The overall population-prevalence of COPD in Elhadjar was estimated at 6.4%. It was more common in men than in women (8.2% vs 4.6%) and increased with age (from 4.5% in those aged 40-49 years to 11.7% in those aged 70 years or older). The overall population-prevalence of modified GOLD stage 2 or higher COPD was 5.5%. Only 1.9% responders reported a diagnosis of COPD. Conclusion: COPD is an under-diagnosed disease in Annaba. A wider use of spirometry would facilitate diagnosis of disease. These findings deserve the attention of the local medical community and policy makers.