Conditions such as COPD and asthma, characterised by abnormal lung function, are the most widespread chronic respiratory diseases globally, with the major burden of morbidity and mortality in low- and middle-income countries (LMICs). Despite the mortality and morbidity burden in LMICs, there have been few studies which have explored the impact of these diseases on the health-related quality of life (HRQoL) of those affected.
Martin and colleagues conducted a cohort study that investigated the natural history of abnormal lung function and its impact on health-related quality-of-life (HRQoL) in rural Malawi. The team discovered the prevalence of COPD nearly doubled from 9.5% to 17.5% within 5 years. Whilst worryingly, the rate of lung function decline in predominantly non-smoking adults in Malawi was comparable with that reported for smokers of more than 15 cigarettes per day in high income countries. In addition, the respiratory symptoms and reductions in lung function experienced by the adults in the study were associated with clinically significant reductions in their HRQoL.
Martin said: “Importantly, this study justifies the implementation of sustainable initiatives for widespread diagnosis and management of chronic respiratory diseases in sub-Saharan Africa. We need to reduce the number of people that develop mild forms of asthma, COPD right through to severe cases of these diseases.”
As such, the high prevalence of COPD in sub-Saharan Africa which adversely affects quality of life of sufferers and causes an accelerated decline in lung function, supports the immediate need for initiatives to improve the diagnosis and management of chronic respiratory diseases.