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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; ... Jones, Rupert; + view all (2024) Characteristics and phenotypes of a COPD cohort from referral hospital clinics in Uganda. BMJ Open Respiratory Research , 11 (1) , Article e001816. 10.1136/bmjresp-2023-001816. Green open access

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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.

Type: Article
Title: Characteristics and phenotypes of a COPD cohort from referral hospital clinics in Uganda
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjresp-2023-001816
Publisher version: https://doi.org/10.1136/bmjresp-2023-001816
Language: English
Additional information: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords: COPD epidemiology, COPD exacerbations, COPD pathology, Female, Humans, Middle Aged, Male, Uganda, Pulmonary Disease, Chronic Obstructive, Phenotype, Referral and Consultation, Hospitals
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10189410
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