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Meta-Analysis
. 2024 Sep 5;16(5):499-511.
doi: 10.1093/inthealth/ihae011.

Chronic obstructive pulmonary disease in East Africa: a systematic review and meta-analysis

Guesh Mebrahtom  1 , Abrha Hailay  1 , Teklewoini Mariye  1 , Teklehaimanot Gereziher Haile  2 , Goitom Girmay  3 , Kidane Zereabruk  1 , Woldu Aberhe  1 , Degena Bahrey Tadesse  1
Affiliations
Meta-Analysis

Chronic obstructive pulmonary disease in East Africa: a systematic review and meta-analysis

Guesh Mebrahtom et al. Int Health. .

Abstract

Chronic obstructive pulmonary disease (COPD) is a common lung disease that causes restricted airflow and breathing problems. Globally, COPD is the third leading cause of death and low- and middle-income countries account for the majority of these deaths. There is limited information on COPD's prevalence in East Africa. Thus the purpose of this systematic review and meta-analysis is to estimate the pooled prevalence of COPD in East Africa.A computerized systematic search using multiple databases was performed in search of relevant English articles from the inception of the databases to August 2023. All the authors independently extracted the data. R and RStudio software were used for statistical analysis. Forest plots and tables were used to represent the data. The statistical heterogeneity was evaluated using I2 statistics. There was heterogeneity between the included articles. Therefore, a meta-analysis of random effects models was used to estimate the overall pooled prevalence of COPD in East Africa. A funnel plot test was used to examine possible publication bias.The database search produced 512 papers. After checking for inclusion and exclusion criteria, 43 full-text observational studies with 68 553 total participants were found suitable for the review. The overall pooled prevalence of COPD in East Africa was 13.322%. The subgroup analysis found the COPD pooled prevalence in the different countries was 18.994%, 7%, 15.745%, 9.032%, 15.026% and 11.266% in Ethiopia, Uganda, Tanzania, Malawi, Sudan, and Kenya, respectively. Additionally, the subgroup analysis of COPD by study setting among community-based studies was 12.132% and 13.575% for hospital-based studies.According to the study's findings, approximately one of every seven individuals in East Africa has COPD, indicating a notably high prevalence of the disease. Thus governments and other stakeholders working on non-communicable disease control should place an emphasis on preventive measures to minimize the burden of COPD.

Keywords: East Africa; chronic obstructive pulmonary disease; meta-analysis.

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Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Flow chart showing the selection of articles for systemic review and meta-analysis of COPD in East Africa, 2023.
Figure 2.
Figure 2.
A funnel plot shows an asymmetric distribution, which is evidence of publication bias across studies.
Figure 3.
Figure 3.
A forest plot shows the pooled prevalence of COPD in Ethiopia from 15 observational studies (18.994% [95% CI 10.632 to 27.356]).
Figure 4.
Figure 4.
A forest plot shows the pooled prevalence of COPD in Uganda from eight observational studies (7.005% [95% CI 3.346 to 10.665]).
Figure 5.
Figure 5.
A forest plot shows the pooled prevalence of COPD in Tanzania from five observational studies (15.745% [95% CI 8.529 to 22.692]).
Figure 6.
Figure 6.
A forest plot shows the pooled prevalence of COPD in Malawi from four observational studies (9.032% [95% CI 4.721 to 13.344]).
Figure 7.
Figure 7.
A forest plot shows the pooled prevalence of COPD in Sudan from four observational studies (15.026% [95% CI 0 to 33.665]).
Figure 8.
Figure 8.
A forest plot shows the pooled prevalence of COPD in Kenya from four observational studies (11.266% [95% CI 0 to 28.338]).
Figure 9.
Figure 9.
A forest plot shows the pooled prevalence of COPD in East Africa among eight community-based observational studies (12.132% [95% CI 7.052 to 17.212]).
Figure 10.
Figure 10.
A forest plot shows the pooled prevalence of COPD in East Africa among 35 hospital-based observational studies (13.575% [95% CI 8.924 to 18.226]).
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