IPCRG: Experts Call for Urgent Prioritisation of COPD Management Strategies to Halt Growing Epidemic in Sub-Saharan Africa

Over 1,000 experts pledge support for FRESH AIR study at ERS congress

AMSTERDAM--(BUSINESS WIRE)--90 per cent of the 3 million annual global deaths from respiratory diseases occur in low- and middle-income countries (LMICs)¹ and by 2025, COPD is predicted to become the third cause of death in Africa, surpassing AIDS/HIV.² The International Primary Care Respiratory Group (IPCRG) is initiating the FRESH AIR Uganda study to quantify the problem of COPD in rural Uganda and test solutions addressing the exposure to tobacco and indoor smoke.

While tobacco smoking has traditionally been the main factor responsible for the development of COPD,³ two million people die every year as a result of exposure to cooking stove smoke.⁴ Approximately 3 billion people, and 90 per cent of rural households, particularly those in Africa, still rely on unprocessed biomass fuel use for cooking and heating.¹ Many people, however, remain unaware of the damage it can cause to respiratory health and that the risk of developing COPD attributable to biomass smoke exposure is similar to the health risk of tobacco smoking.⁵

Frederik van Gemert, lead researcher of the the FRESH AIR Uganda study commented on the issue: ‘The total deaths from COPD are set to increase by more than 30 per cent in the next 10 years unless urgent action is taken. There is a big job to stop this public health tragedy. We need to increase awareness about COPD, strengthen local education programmes about the impact of biofuel use, and encourage the testing of intervention programs and then share the results.’

In rural Africa, treatment for conditions like COPD, is focused on ad-hoc treatment of acute exacerbations instead of the prevention of disease. In addition, diagnostic tests like spirometry are scarcely available, and inhaled medication is often limited or not affordable.⁶ COPD and its risk factors are unfamiliar to the public and often physicians in many regions of Africa. COPD is often not recognised, as symptoms of cough are frequently attributed to the acceptable irritant effect of smoking, to tuberculosis or to ageing.

Siân Williams, Executive Officer IPCRG, commented ‘We are supporting this inititative to build convincing evidence for policy makers about the impact of COPD in local communities in sub-saharan Africa so that low-cost, locally appropriate and sustainable interventions to control these diseases and their risk factors can be tested and implemented. We are delighted to receive support from the clinical respiratory community and urge people to draw attention to this issue.’

The petition, launched at the ERS congress, Amsterdam, The Netherlands has attracted over 1,000 signatures to date and is open until December 2011 on www.freshairuganda.co.uk

Notes to editors

About the IPCRG

The International Primary Care Respiratory Group (IPCRG) is a charity that represents national primary care groups from across the world. It aims to raise standards of care in individual countries and globally, through collaborative “real life” research, innovation, dissemination of best practice, education and advocacy.

IPCRG is supporting the FRESH AIR study as an example of “innovative research relevant to the African context”⁷ that will enable us to quantify the problem in Uganda and test solutions addressing exposure to tobacco and indoor smoke. The results of the study will be presented to policy-makers with the end goal that NCDs are considered alongside communicable diseases in any prioritisation exercise.

The IPCRG’s ethos is to offer peer support, by enabling primary care clinicians with a respiratory interest to work alongside local primary care and public health teams. The IPCRG’s ultimate goal is to support local clinicians to establish their own community of practice that can then engage with international peers to share knowledge and understanding.

About the FRESH AIR Uganda Study

The goals of the FRESH AIR survey in Uganda are to:

• increase the awareness amongst healthcare workers about the impact of biomass fuel smoke inhalation and tobacco use on respiratory health
• increase access to diagnostic tests and inhaled medication
• identify practical solutions to reduce exposure to biomass smoke
• provide convincing evidence to policy makers about the impact of COPD in local communities.

This epidemiological study will investigate the prevalence of COPD and its risk factors in resource-poor settings of a rural area in Uganda among 300 men and 300 women above the age of 30 years. It will measure the direct exposure to biomass smoke (PM₂̦₅), 24-hour mean exposure, in the indoor environment of resource-poor settings of a rural area, combined with a qualitative assessment of the cooking tradition and behavior of people with COPD. The burden of COPD will be evaluated in terms of quality of life, limitations, respiratory symptoms and exacerbation assessment.

Fresh Air is funded by IPCRG, supported by a grant from Mundipharma International Ltd.

References

1. WHO. Global surveillance, prevention and control of Chronic Respiratory Diseases: a comprehensive approach. World Health Organization 2007.
2. WHO. Global Alliance against Respiratory Diseases: action plan 2008-2013. 2008.)
3. (Buist AS, et al. Int J Tuberc Lung Dis 2008 07;12(7):703-708)
4. (Global Alliance for Clean Cookstoves. Cookstoves and Non-Communicable Diseases. September 2011.)
5. Salvi S, Barnes PJ. Is exposure to biomass smoke the biggest risk factor for COPD globally? Chest 2010;138(1):3-6.
6. Bousquet J, Dahl R, Khaltaev N. Global alliance against chronic respiratory diseases. Allergy 2007 03;62(3):216-223)
7. The Brazzaville Declaration on Non-Communicable Diseases Prevention and Control In The Who African Region. Who Regional Office For Africa. April 2011. Clause 10.