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. 2021 Feb 11;16(2):e0246850.
doi: 10.1371/journal.pone.0246850. eCollection 2021.

Incidence and predictors of COPD mortality in Uganda: A 2-year prospective cohort study

Patricia Alupo  1 , Adaeze C Wosu  1   2 , Abdallah Mahofa  3 , Levicatus Mugenyi  1 , Daniel Semakula  3 , Winceslaus Katagira  1 , Bruce Kirenga  1   3
Affiliations

Incidence and predictors of COPD mortality in Uganda: A 2-year prospective cohort study

Patricia Alupo et al. PLoS One. .

Abstract

Background: Data is lacking on outcomes among COPD patients in sub-Saharan Africa. The objective of the study was to assess the incidence and predictors of mortality among COPD patients enrolled in the Uganda Registry for Asthma and COPD.

Research question: What is the Incidence and predictors of mortality among COPD patients in Uganda?

Study design and methods: Individuals with a diagnosis of COPD at six hospitals in Uganda were enrolled into the registry, and followed every six months. Mortality was ascertained through post-mortem reports and verbal autopsies. Mortality rates (MR), mortality rate ratios (MRR), and hazard ratios (HR) were computed to assess associations between socio-demographic, behavioural, and clinical characteristics at enrolment into the registry and mortality up to two years after.

Results: We enrolled 296 COPD patients. Median age was 60 years, and 51·3% were male. The overall mortality rate was 95·90 deaths/1000 person-years. COPD severity by post-bronchodilator FEV1 was the strongest risk factor for mortality. Compared to stage 1, adjusted hazard ratios were as follows for stage 4: 9·86 (95%CI: 1·70-57·14, p = 0·011), stage 3: 6·16 (95%CI: 1·25-30·32, p = 0·025), and stage 2: 1·76 (95%CI: 0·33-9·48, p = 0·51). Underweight patients had a higher incidence of mortality compared to normal weight patients (MRR: 3·47 (95%CI: 1·45-8·31, p = 0·0026).

Conclusion: Among COPD patients in Uganda, two-year mortality is high, and disease severity at baseline was the strongest risk factor for mortality. Our findings suggest the need for early, accurate, diagnosis and management of COPD, to potentially improve survival.

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Conflict of interest statement

The authors have declared that they have no competing interests exist.

Figures

Fig 1
Fig 1. Survival probability among COPD patients over 2 years (n = 250).
Fig 2
Fig 2. Survival probability according to COPD severity (staging by baseline post-bronchodilator FEV1).
Fig 3
Fig 3. Survival probability according to underweight status.
See this image and copyright information in PMC

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