Prevalence of Chronic Obstructive Pulmonary Disease in the Attecoube Lagune Neighborhood of Abidjan (Cote D'ivoire)

Prevalence of Chronic Obstructive Pulmonary Disease in the Attecoube Lagune Neighborhood of Abidjan (Cote D'ivoire) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence of Chronic Obstructive Pulmonary Disease in the Attecoube Lagune Neighborhood of Abidjan (Cote D'ivoire) Loukou Leandre KONAN, MARIE LAURE ESSIS, Affou Séraphin WOGNIN, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4195386/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction : Chronic obstructive pulmonary disease (COPD) is a severe, long-term, life-threatening respiratory illness. The aim of this study was to determine the prevalence of COPD and the factors associated with its prevention in the population of the Attecoube Lagune neighborhood of Abidjan, Côte d'Ivoire. Material and methods : A descriptive and analytical cross-sectional study lasting 2 months was carried out in the Attecoube Lagune neighborhood of Abidjan in 2022. A questionnaire was used to collect information on sociodemographic, clinical and environmental characteristics. Baseline spirometry and a beta mimetic test were performed in all subjects surveyed to explore their respiratory function. Data analysis was performed using stata15.1 software. Results : A total of 170 residents were surveyed, including 103 women and 67 men, with a sex ratio (M/F) of 0.65. Mean age was 35.92 ± 15.28 years. The most frequent respiratory symptoms were chest tightness (29.41%), dyspnoea (28.82%) and cough (22.35%). The prevalence of COPD was 5.29% among Attecoube Lagune neighborhood residents. Tobacco smoke was strongly associated with COPD [OR = 7, 06; IC95%: 1.00–10.60; P < 0.05]. Conclusion : Chronic obstructive pulmonary disease (COPD) was strongly associated with tobacco smoke in Attecoube Lagune neighborhood. Awareness-raising campaigns on the dangers of tobacco and health promotion are needed in this commune. Chronic obstructive pulmonary disease air pollution Attecoube Lagune neighborhood Abidjan Cote d’Ivoire Figures Figure 1 Figure 2 Figure 3 INTRODUCTION COPD is a chronic inflammatory respiratory disease characterized by permanent, progressive and non-reversible bronchial obstruction [ 1 ]. It affects 329 million people, i.e., almost 5% of the world's population [ 2 ][ 3 ]. Its progression is marked by numerous life-threatening complications [ 4 ]. COPD is currently the 3rd leading cause of death, with 3.23 million deaths worldwide in 2019 [ 5 ]. Around 90% of deaths occur in low- and middle-income countries (LMICs) [ 5 ]. In addition to increasing mortality and morbidity, COPD also represents a significant socio-economic burden in LMICs, due to its impact on work productivity. However, despite the health and economic burden of this condition, it remains poorly understood by the general public, patients themselves and physicians [ 6 ]. Moreover, a few studies have been carried out on COPD, particularly in sub-Saharan Africa. In fact, the disease remains poorly understood and under-diagnosed in sub-Saharan Africa [ 7 ]. Exacerbation is the most frequent circumstance in which COPD is discovered, and diagnosis is generally delayed [ 7 ]. In the West African sub-region, Burkina Faso, Senegal and Côte d'Ivoire reported hospital prevalences of 6.45%, 4.13% and 2.47% respectively [ 8 ]. Most studies carried out in the West African region in general, and in Côte d'Ivoire in particular, have focused on patients attending hospital facilities. On the other hand, this condition has been little studied, particularly in community settings, hence the interest of this study, whose aim is to determine the prevalence of COPD and the associated factors in order to prevent it in the population of Attecoube Lagune neighborhood in Abidjan, Côte d'Ivoire. MATERIAL AND METHODS 1. Study framework Attecoube is one of the thirteen municipalities in the District of Abidjan, located between the municipalities of Adjamé and Yopougon. It has a population of 207,586 and covers an area of 68.2 km 2 . Attecoube is divided into right and left banks, and comprises 35 neighborhoods and 5 villages. Economic life in this commune is essentially dominated by trade and craft activities. (Figure 1) 2. Type of study This was a descriptive and analytical cross-sectional study conducted over a two-month period from February 15, 2022 to April 15, 2022 in the Attecoube Lagune neighborhood. 3. Population The study population was made up of residents of the Attecoube Lagune neighborhood, living between Banco Bay and Peace Boulevard. Inclusion criteria Residents aged 18 and over who gave a positive opinion were included in the study. Non-inclusion criteria Pregnant women, sick people, non-consenting residents and anyone unable to perform a spirometry test were excluded from the study. 4. Sampling and sample size Starting from the center of the district, the right-hand side of the entrance to the Naval Training Center (CNI) was randomly selected as the starting point for data collection. We progressed in the direction of the interchange, with a sampling step equal to 2. We proceeded in this way to the right and left to visit the selected concessions. Within each concession, all individuals who met the inclusion criteria were exhaustively enrolled. The StatCalc program in Epi Info version 7.2.1 was used to calculate our minimum sample size. A minimum sample size of 153 was obtained. The elements used to calculate the minimum sample size were: - Total population of Attecoube Lagune = 2,700 (Adjamé-Plateau-Attecoube District Report, 2021). - Prevalence of respiratory diseases in Attecoube = 12%. (District Adjamé-Plateau-Attecoube report, 2021). - Alpha risk = 5%. - Confidence interval = 95%. With a 10% increase, our final sample size was 168 people. 5. Data collection As part of this study, three investigators, all students, received two days' classroom training on the research protocol and the various data collection tools and media. This training verified their understanding of research procedures (recruitment, consent and follow-up). In addition, a pre-test of the data collection form was carried out on February 10, 2022 in the Attecoube Sebroko neighborhood, and enabled the various shortcomings to be corrected. In addition, spirometry was carried out by a team consisting of a nurse and a doctor, both specialists in functional exploration and highly experienced. Data collection took place in two phases. The first phase involved completing a questionnaire with each subject included in the study. The questionnaire collected information on socio-demographic characteristics, length of residence in the neighborhood, smoking habits, degree of exposure to pollution and health data. The respiratory symptoms sought were those suggestive of asthma or chronic obstructive pulmonary disease (dry cough, wheezing, dyspnea and chest tightness), and rhinoconjunctivitis (rhinorrhea, nasal obstruction, nasal tingling, sneezing, lacrimation, ocular redness). The second phase consisted in performing pulmonary auscultation and spirometry on each subject included in the study. Spirometry was performed using a Winspiro PRO6.5 MIR portable spirometer, followed by a reversibility test performed after inhalation of a 400 µg dose through an inhalation chamber. This test was carried out in accordance with the recommended guidelines of the American Thoracic Society (ATS) by two technicians (a nurse and a doctor) who were well trained to perform the said test. The parameters measured were: forced vital capacity (FVC) in liters, forced expiratory volume in one second (FEV1) in liters per second and the Tiffeneau ratio (FEV1/FVC) expressed as a percentage. The pathological threshold was defined by a fall of more than 20% in FEV1, FVC, the pathological threshold of the Tiffeneau ratio was defined by a fall of more than 12% (FEV1/FVC < 80% of predicted) according to the ATS/ERS Criteria. The theoretical standard used is that of the African ethnic group incorporated into the spirometer software, which takes into account the subjects' sex, age, weight and height. 6. Operational definition - Obstructive ventilatory disorder (OVD) is defined by a FEV1/FVC ratio of less than 80% of predicted. The severity of the disorder is assessed on the basis of FEV1 - FEV1 > 80%: mild - FEV1 50-80%: moderate - FEV1 30-50%: severe - FEV1 < 30%: very severe - Reversibility of obstruction: gain in FEV1 of more than 12% (relative value) and 200ml (absolute value). 7. Data analysis Univariate analysis was used to describe the variables: age, gender, height, weight, smoking, BMI, length of residence, occupation, level of education, level of exposure to pollution, respiratory symptoms (cough, dyspnea, wheezing, chest tightness) and family history of asthma. The dependent variable: COPD (non-reversible TVO after beta 2 mimetic inhalation) was obtained from the results of spirometry performed on the inhabitants of Attecoube Lagune neighborhood. A bivariate analysis was used to search for possible links between the dependent variable (COPD) and the independent variables (age, sex, smoking status, length of residence, level of exposure, occupational activity and level of education). Independent variables with a significance level p ≤ 0.20 were included in the multivariate analysis. Multiple logistic regression models were constructed to search for a link between the dependent variable and the selected independent variables. The top-down stepwise logistic regression method was adopted with (p < 0.05). 8. Ethical considerations Verbal and informed consent was obtained from the respondents, before proceeding with the interviews. The questionnaire was only administered once consent had been obtained. Anonymity and confidentiality were respected, and initials were used instead of names. Interviews were conducted in French or the local language, and in private locations to ensure confidentiality. Approval for the study was granted by the internal ethics committee of the National Institute of Public Health and the District Sanitaire Adjamé -Plateau - Attecoube. RESULTS 1. Socio-demographic characteristics The study population comprised 103 women and 67 men, with a sex ratio (M/F) of 0.65. Mean age was 35.92 ± 15.28 years. Over 41% of the population had secondary education or higher. Some 66% of residents had lived in the neighborhood for more than 10 years. Smoking status was found in 5.30% of residents, and obesity in over 26% of the population. (Table 1 ) Table 1 : Socio-demographic characteristics of Attecoube Lagune neighborhood residents in 2022 Characteristics Staff (N) = 170 Percentage (%) Gender Man 67 39.40 Woman 103 60.60 Age range 35 years ≤ 96 56.50 35 years > 74 43.50 Study level None 61 35.90 Primary 38 22.30 Secondary and higher 71 41.80 Time of residence 10 years ≤ 58 34.10 10 years > 112 65.90 Tobacco status No 161 94.70 Yes 9 5.30 Body mass index (BMI) underweight 6 3.53 Normal weight 83 48.82 Overweight 36 21.18 Obesity 45 26.47 2. Prevalence of respiratory symptoms among residents of Attecoube Lagune neighborhood in 2022 The most frequent respiratory symptoms were, in order of importance, chest tightness (29.41%), dyspnea (28.82%), sneezing (22.94%) and cough (22.35%). (Figure 2 ) Two socio-demographic characteristics were statistically associated with the occurrence of COPD in the population. The prevalence of COPD increased with age, but this difference was not statistically significant (Table 2 ) . Table 2 : Socio-demographic characteristics of Attecoubé Lagune neighbourhood residents with COPD in 2022 Caracteristics COPD (n%) Total (n%) P No Yes Gender 0.09 Female 100 (62.1) 3 (33.33) 103 (60.59) Male 61 (37.89) 6 (66.67) 67 (39.41) Occupation 0.47 Others 95 (59.01) 6 (66.67) 101 (59.41) Traders 66 (40.99) 3 (33.33) 69 (40.59) Level of exposition to air pollution 0.62 weak 37 (22.98) 1 (11.11) 38 (22.35) average 64 (39.75) 3 (33.33) 67 (39.41) strong 60 (37.27) 5 (55.56) 65 (38.24) Smoker 0.13 No 151 (39.79) 7 (77.78) 158 (92.94) Yes 10 (6.21) 2 (22.22) 12 (7.06) Marital status 0.048 Singles 147 (91.30) 6 (66.67) 153 (90.00) Married 14 (8.70) 3 (33.33) 17 (10.00) Body mass index (BMI) 0.67 Underweight 6 (3.73) 0 (0.00) 6 (3.53) Normal 79 (49.03) 4 (44.44) 83 (48.82) Overweight 35 (21.74) 1 (11.11) 36 (21.18) Obesity 41 (25.47) 4 (44.44) 45 (26.47) Age range (Years) 18-30 77 (47.83) 2 (22.22) 79 (46.47) 0.265 30-45 45 (27.95) 3 (33.33) 48 (28.24) > 45 39 (24.22) 4 (44.44) 43 (25.29) The prevalence of COPD in the Attecoube Lagune neighborhood population was estimated at 5.29%. (Figure 3) 4. Risk factors for COPD in Attecoube Lagune neighborhood in 2022 Multivariate logistic regression revealed a risk factor for COPD that was smoking status [OR: 7.06; IC95%:1.00 - 10, 60; p < 0.05]. Smokers in the neighborhood were 7.06 times more likely to develop COPD than non-smokers. Exposure level was not associated with COPD (table 3 ). Tableau 3: Risk factors for COPD in Attecoube lagoon neighborhood in 2022 COPD risk factors OR IC95% P Age range [18-30, years] 1 [30-45 years] 1.53 0.22 – 10.7 > 0.67 > 45 ans 2.30 0.33 – 18.2 > 0.37 Level of exposure Weak 1 Average 1.25 0.12 – 13.60 > 0.85 Strong 2.64 0.28 –14.68 > 0.39 Marital status Single 1 Married 5.22 0.96 – 18.43 > 0.05 Time of residence > 10 years 1 ≤ 10 years 0.65 0.12 – 3.64 > 0.63 Smoker No 1 Yes 7.06 1.00 – 10.60 < 0.05 DISCUSSION Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide [ 9 ]. Almost 90% of COPD deaths occur in low- and middle-income countries [ 9 ]. It is often a neglected disease in these countries. Moreover, COPD prevalence studies are rare in sub-Saharan Africa [ 10 ]. The aim of this study was to determine the prevalence of COPD and associated factors in order to prevent it in the population of Attecoube Lagune neighborhood in Abidjan. To our knowledge, this community-based study of COPD using spirometry is one of the first of its kind in Côte d'Ivoire. COPD generally occurs in smokers from the age of 40. As a result, most studies choose this age as the reference point. However, apart from tobacco, certain factors are likely to induce this condition. In fact, local practices related to COPD may involve a younger population than in Western contexts [ 11 ]. In Africa, for example, exposure to biomass fuels can lead to a high involvement of young subjects in COPD. In fact, just as tobacco smoke is the main risk factor for COPD in developed countries, domestic smoke from biomass combustion is an important risk factor for COPD in developing countries [ 12 ]. In our study, we chose the age of 18 instead of 40. This choice was justified by the fact that the majority of the population of the Attecoube Lagune neighborhood worked in small trades and had no stable income. Consequently, they generally used biomass for cooking. This choice is also justified by the fact that the age of majority in Côte d'Ivoire is 18. Our choice is similar to that of a study in Cameroon, which adopted 19 as the reference age [ 11 ]. The prevalence of COPD was estimated at 5.29% among Attecoube Lagune neighborhood residents. It was low, but higher than that obtained in the Cameroon community study, estimated at 2.9% [ 11 ], which adopted an age of 19 years, similar to our choice. The difference in prevalence observed could be explained by the definition of COPD adopted in each study. In the present study, the definition of COPD was based on the fixed FEV1/FVC ratio. Whereas in the Cameroon study, COPD was defined as a FEV1/FVC ratio < defined GLI - LLN. In studies using the fixed FEV1/FVC ratio definition, an overestimation of COPD prevalence was observed due to physiological decline with age. Studies based on the fixed FEV1/FVC ratio carried out in Malawi, Tanzania, Ethiopia and Uganda reported prevalences of 17.8% [ 10 ], 17.5% [ 13 ], 16.2% [ 14 ] and 13.6% [ 15 ] respectively. The prevalence of our study was very low compared with those of these studies. The difference in prevalence observed between these studies and ours could be due to variations in the study population, sample size and methodology [ 10 ]. In our study, the sample size of 170 was very small compared with 734 in Ethiopia [ 10 ], 869 in Tanzania [ 13 ] and 588 in Uganda [ 14 ]. In Uganda, the prevalence of smoking was 36%, well above the prevalence in our study (7.06%). In the Ethiopian, Tanzanian and Malawian studies, the high use of biomass in poorly ventilated dwellings was reported. The combined action of all these factors could explain this marked difference in prevalence. In contrast, studies based on a defined FEV1/FVC < GLI - LLN ratio revealed low prevalences such as those by Pefura.Y et al (4%) in 2016 in Tanzania [ 14 ], Kayongo et al (6.22%) in 2017 in Uganda [ 15 ]. The prevalence of COPD can vary considerably depending on whether the definition adopted is based on the use of spirometry or not [ 9 ]. In some cases, case definitions were based on the British Medical Research Council (BMRC) questionnaire for chronic bronchitis, in which there was an affirmative response to the definition of "daily productive cough for at least three consecutive months for more than two consecutive years", and on a previous diagnosis of COPD by a physician [ 16 ]. Two meta-analyses of 13 African studies revealed that prevalences obtained with spirometry were higher than those obtained on the basis of symptoms [ 9 ]. The mean prevalence of COPD in symptom-defined cases was estimated at 4%, while those defined by spirometry had a mean prevalence of 13.4% [ 9 ]. This could be justified by the fact that only spirometry could objectively diagnose bronchial obstruction. However, some providers did not always position spirometry as first-line treatment, given its non-routine availability [ 17 ]. This situation confirms the underestimation of COPD in Africa. In our study, the prevalence of COPD increased with age. In fact, the prevalences were estimated at 2.53%, 6.25% and 9.30% respectively in the age groups [18yrs − 30yrs], ]30yrs − 45yrs] and over 45 years. However, this difference was not significant. This variation in COPD with age has been observed in other studies [ 11 ] [ 10 ]. The prevalence of COPD tended to increase with age, and old age was considered a risk factor for developing COPD [ 18 ] [ 19 ]. The association of COPD with old age can be attributed to greater exposure to risk factors and a physiological decline in lung function that appears around the age of 30 to 40 [ 20 ] [ 21 ]. In terms of factors, smoking residents were 7.06 times more likely to develop COPD (p < 0.05) than non-smoking residents. Indeed, active smoking is the main risk factor for COPD [ 22 ] [ 23 ] [ 24 ]. The prevalence of smoking in our study was estimated at 7.06%. This prevalence was higher than that of active smoking (5.66%) obtained in the study by TETCHI et al. (2022) carried out in a general population and involving a population ranging in age from 20 to 79 years [ 24 ]. Level of exposure to air pollution was not associated with COPD in our study. This could be justified by the fact that air quality was not actually measured. These are subjective data from the questionnaire administered at the surveys. The main limitation of this study was the absence of air quality measurement. The main strength of this study was the performance of baseline spirometry and beta 2 mimetic testing on all enrolled residents of Attecoube Lagune neighborhood. This is the very first community-based COPD study to use spirometry. Future studies are needed to better characterize this chronic respiratory condition, which appears to be poorly understood and neglected. CONCLUSION Chronic obstructive pulmonary disease (COPD) is a chronic, disabling respiratory illness. It is a non-curable but preventable condition. It is strongly associated with tobacco smoke. It would be desirable for the competent authorities in the municipality of Attecoube to undertake awareness-raising campaigns on tobacco in order to reduce the level of air pollution and offer their residents a better quality of life. Declarations Ethical approval Ethics approval was obtained from the Comité Scientifique Interne, Institut National de Santé Publique, Abidjan, Côte d’Ivoire (N o 165). Consent to participate A written informed consent was obtained from all participants in the study. Participation was voluntary and participants were informed of their right to withdraw from the study when they wished to do so. All the participants were aware of the study's purpose, risks, and benefits. Data were collected, managed, and analyzed in a way to ensure the confidentiality of study participants. All procedures performed in this study involving human participants were in accordance with the ethical standards of the national ethic review committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent for publication Not applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the first author on reasonable request. Competing interest The authors declare that there are no conflicts of interest regarding the publication of this article. Funding No funding received. Authors' contributions LLK wrote the study protocol and collected the data. He analyzed and interpreted the data then wrote the manuscript. EMLE made critical revision of the manuscript for important intellectual content. ASW, OBY and IT read and approved the final manuscript. Therefore, all the authors mentioned in this article contributed to the production of the work we are submitting, and the contents of the manuscript have never been published. They agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Acknowledgements This study was possible thanks to the leadership and management of the Directorate of the Public Health National Institute and the support of the Health District Adjame-Plateau-Attecoube of the Health Region Abidjan-1. We thank the management of the Director of the Health District Adjame-Plateau-Attécoubé who accepted that our study took place in this structure. We are particularly grateful young people from the Attecoube Lagune neighborhood who raised awareness and mobilized the population for this study. We would like to express our special thanks to the local youth president for her involvement and to the population of Attecoube Lagune neighborhood who allowed us to collect their data. References Dia Kane Y, Thiam K, Diallo M, Nidaye EHM, Cissé MF, Mbaye FBR et al. Facteurs d’exacerbations aiguës (EA) de broncho-pneumopathie chronique obstructive (BPCO) à la clinique de pneumo-phtisiologie du centre hospitalier national universitaire (CHNU) de Fann, Dakar (Sénégal) [Factors in acute exacerbations (AE) of chronic obstructive pulmonary disease (COPD) at the pneumo-phtisiology clinic of the Fann national university hospital, Dakar (Senegal)]. Rev Mal Respir. 2019;36. Rycroft CE, Heyes A, Lanza L, Becker K. Epidemiology of chronic obstructive pulmonary disease: A literature review. Int J COPD. 2012;7:457–94. Ahmed R, Robinson R, Mortimer K. The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa. Malawi Med J. 2017;29(2):203–11. Prudhomme A. Maladies respiratoires: BPCO et asthme [Respiratory diseases: COPD and asthma]. In: Traité de santé publique. Lavoisier; 2016. p. 523. http://www.cairn.info/traite-de-sante-publique-9782257206794-page-523.htm . World Health Organization. Bronchopneumopathie chronique obstructive (BPOC) [Chronic obstructive pulmonary disease (COPD)]. 2023. http://www.who.int/mediacentre/factsheets/fs315/fr/ . Keriou F, Damen A, Ahmed Azi M, Moumeni A. La BPCO méconnue [The misunderstood COPD]. Rev des Mal Respir Actual. 2022;14(1). Anon JC, Dembele R, Toh-Bi Y, Yeo L, Dje-Bi H, Achi V et al. Contribution pour améliorer la prise en charge de la BPCO en Afrique noire [Contribution to improving COPD management in Black Africa]. Rev des Mal Respir Actual. 2020;12(1). Achi HV, Dje-Bi H, Yeo L, Tadet JON, N’Dhatz-Sanogo M. La BPCO dans le service de pneumologie du CHU de Bouaké (RCI) [COPD in the pulmonology department of the University Hospital Center of Bouaké, Ivory Coast]. Rev Mal Respir. 2017;34. World Health Organization. Bronchopneumopathie chronique obstructive (BPCO) [Chronic obstructive pulmonary disease (COPD)]. 2023. pp. 1–6. https://www.who.int/fr/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd ). Woldeamanuel GG, Mingude AB, Geta TG. Prevalence of chronic obstructive pulmonary disease (COPD) and its associated factors among adults in Abeshge District, Ethiopia: A cross sectional study. BMC Pulm Med. 2019;19(1). Massongo M, Balkissou AD, Endale Mangamba L-M, Poka Mayap V, Ngah Komo ME, Nsounfon AW, et al. Chronic Obstructive Pulmonary Disease in Cameroon: Prevalence and Predictors—A Multisetting Community-Based Study. Pulm Med. 2023;2023:1–14. Siddharthan T, Pollard SL, Jackson P, Robertson NM, Wosu AC, Rahman N et al. Effectiveness of low-dose theophylline for the management of biomass-associated COPD (LODOT-BCOPD): study protocol for a randomized controlled trial. Trials. 2021;22(1). Magitta NF, Walker RW, Apte KK, Shimwela MD, Mwaiselage JD, Sanga AA et al. Prevalence, risk factors and clinical correlates of COPD in a rural setting in Tanzania. Eur Respir J. 2018;51(2). Pefura-Yone EW, Kengne AP, Balkissou AD, Magne-Fotso CG, Ngo-Yonga M, Boulleys-Nana JR et al. Prevalence of obstructive lung disease in an African country using definitions from different international guidelines: A community based cross-sectional survey. BMC Res Notes. 2016;9(1). Kayongo A, Wosu AC, Naz T, Nassali F, Kalyesubula R, Kirenga B, et al. Chronic Obstructive Pulmonary Disease Prevalence and Associated Factors in a Setting of Well-Controlled HIV, A Cross-Sectional Study. COPD J Chronic Obstr Pulm Dis. 2020;17(3):297–305. Ale BM, Ozoh OB, Gadanya MA, Li Y, Harhay MO, Adebiyi AO et al. Estimating the prevalence of COPD in an African country: evidence from southern Nigeria. J Glob Heal Rep. 2022;6. Mehrotra A, Oluwole AM, Gordon SB. The burden of COPD in Africa: A literature review and prospective survey of the availability of spirometry for COPD diagnosis in Africa. Volume 14. Tropical Medicine and International Health; 2009. Lõpez-Campos JL, Tan W, Soriano JB. Global burden of COPD. Volume 21. Respirology. Blackwell Publishing; 2016. pp. 14–23. Jarhyan P, Hutchinson A, Khaw D, Prabhakaran D, Mohan S. Prevalence of chronic obstructive pulmonary disease and chronic bronchitis in eight countries: a systematic review and meta-analysis. Bull World Health Organ. 2022;100(3):216–30. Raherison C, Girodet PO. Epidemiology of COPD. Eur Respiratory Rev. 2009;18:213–21. Nugmanova D, Feshchenko Y, Iashyna L, Gyrina O, Malynovska K, Mammadbayov E et al. The prevalence, burden and risk factors associated with chronic obstructive pulmonary disease in Commonwealth of Independent States (Ukraine, Kazakhstan and Azerbaijan): Results of the CORE study. BMC Pulm Med. 2018;18(1). Kamal R, Srivastava AK, Kesavachandran CN. Meta-analysis approach to study the prevalence of chronic obstructive pulmonary disease among current, former and non-smokers. 2, Toxicol Rep. 2015. Awokola BI, Amusa GA, Jewell CP, Okello G, Stobrink M, Finney LJ et al. Chronic obstructive pulmonary disease in sub-Saharan Africa. Int J Tuberc Lung Dis. 2022;26(3). Guillien A, Soumagne T, Dalphin JC, Degano B. COPD, airflow limitation and chronic bronchitis in farmers: A systematic review and meta-analysis. Occup Environ Med. 2019;76(1). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4195386","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":286416635,"identity":"f2df845c-1720-47ab-af36-fb933db63d71","order_by":0,"name":"Loukou Leandre KONAN","email":"","orcid":"","institution":"National Public Health Institute of Abidjan","correspondingAuthor":false,"prefix":"","firstName":"Loukou","middleName":"Leandre","lastName":"KONAN","suffix":""},{"id":286416636,"identity":"ce46d4fd-f31f-4af7-a7da-babc68423e93","order_by":1,"name":"MARIE LAURE ESSIS","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBklEQVRIiWNgGAWjYJCCAyCCjYH5wIHEfzYMDBIgrg1RWtgSH3xgS4NqSSPKMh5jwxlshwlr4ec//vDgzxy7fD72BjNpHp7zif2zmw8+YEi4h1OL5Iwcg8O825It23gOpEnzSNxOnHHnWLIBQ0IxTi0GN3gYDjNuYzZgk0g4Js1jcDux4UaOmQTjjwScWuzPH39w8Oe2egM2+Ydt0jwJ5xLng7QwJODWAnSCwQHebYeBtjAzG84AhvMGQlokboD9ctyAjSeN8cHHhmTjjTfSkg0S8Gjh7z/++OPPbdUG8u3nPxxIbLCTnXcj+eCDD3i0YADHBhBJggZgeJCieBSMglEwCkYGAAB1CFmdDFLhagAAAABJRU5ErkJggg==","orcid":"","institution":"National Public Health Institute of Abidjan","correspondingAuthor":true,"prefix":"","firstName":"MARIE","middleName":"LAURE","lastName":"ESSIS","suffix":""},{"id":286416637,"identity":"49b50163-8707-4bff-892e-994ea8b19287","order_by":2,"name":"Affou Séraphin WOGNIN","email":"","orcid":"","institution":"University Peleforo Gon Coulibaly of Korhogo","correspondingAuthor":false,"prefix":"","firstName":"Affou","middleName":"Séraphin","lastName":"WOGNIN","suffix":""},{"id":286416638,"identity":"4ca4644f-9544-455c-9315-ca16cebc4143","order_by":3,"name":"Ossey Bernard YAPO","email":"","orcid":"","institution":"University Nangui Abrogoua of Abidjan","correspondingAuthor":false,"prefix":"","firstName":"Ossey","middleName":"Bernard","lastName":"YAPO","suffix":""},{"id":286416639,"identity":"fc624400-1d73-4637-a7fb-d59496fecfce","order_by":4,"name":"Issaka TIEMBRE","email":"","orcid":"","institution":"University Felix Houphouet Boigny of Abidjan","correspondingAuthor":false,"prefix":"","firstName":"Issaka","middleName":"","lastName":"TIEMBRE","suffix":""}],"badges":[],"createdAt":"2024-03-31 11:29:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4195386/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4195386/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":54093530,"identity":"fb3de6b4-670e-4008-b3de-fae25edb2102","added_by":"auto","created_at":"2024-04-04 13:42:39","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":304488,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eOverview of the study area\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-4195386/v1/f54408dd2fda8d004e5f9585.png"},{"id":54093531,"identity":"aba0bcd5-41cd-492b-b20c-f2309561f9df","added_by":"auto","created_at":"2024-04-04 13:42:39","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":114266,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eRespiratory symptoms in the Attecoube Lagune neighborhoodpopulation\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-4195386/v1/92d709cbedcc9eb30211b7a8.png"},{"id":54093532,"identity":"7a83a5fe-3b48-474d-a64f-5f959f5fb5dd","added_by":"auto","created_at":"2024-04-04 13:42:40","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":22652,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003ePrevalence of COPD among residents of Attecoube Lagune neighborhoodin 2022\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-4195386/v1/a8dd404b2cb2e89c9bda9f71.png"},{"id":64685691,"identity":"6271f24f-8d76-4858-97ff-494520747a0d","added_by":"auto","created_at":"2024-09-17 14:47:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1215051,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4195386/v1/111b872c-4bcb-4e14-a933-48653df7863f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003ePrevalence of Chronic Obstructive Pulmonary Disease in the Attecoube Lagune Neighborhood of Abidjan (Cote D'ivoire)\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eCOPD is a chronic inflammatory respiratory disease characterized by permanent, progressive and non-reversible bronchial obstruction [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. It affects 329\u0026nbsp;million people, i.e., almost 5% of the world's population [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e][\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Its progression is marked by numerous life-threatening complications [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. COPD is currently the 3rd leading cause of death, with 3.23\u0026nbsp;million deaths worldwide in 2019 [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Around 90% of deaths occur in low- and middle-income countries (LMICs) [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In addition to increasing mortality and morbidity, COPD also represents a significant socio-economic burden in LMICs, due to its impact on work productivity.\u003c/p\u003e \u003cp\u003eHowever, despite the health and economic burden of this condition, it remains poorly understood by the general public, patients themselves and physicians [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Moreover, a few studies have been carried out on COPD, particularly in sub-Saharan Africa. In fact, the disease remains poorly understood and under-diagnosed in sub-Saharan Africa [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Exacerbation is the most frequent circumstance in which COPD is discovered, and diagnosis is generally delayed [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In the West African sub-region, Burkina Faso, Senegal and C\u0026ocirc;te d'Ivoire reported hospital prevalences of 6.45%, 4.13% and 2.47% respectively [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Most studies carried out in the West African region in general, and in C\u0026ocirc;te d'Ivoire in particular, have focused on patients attending hospital facilities. On the other hand, this condition has been little studied, particularly in community settings, hence the interest of this study, whose aim is to determine the prevalence of COPD and the associated factors in order to prevent it in the population of Attecoube Lagune neighborhood in Abidjan, C\u0026ocirc;te d'Ivoire.\u003c/p\u003e"},{"header":"MATERIAL AND METHODS","content":"\u003cp\u003e\u003cstrong\u003e1. Study framework\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAttecoube is one of the thirteen municipalities in the District of Abidjan, located between the municipalities of Adjam\u0026eacute; and Yopougon. It has a population of 207,586 and covers an area of 68.2\u0026nbsp;km\u003csup\u003e2\u003c/sup\u003e. Attecoube is divided into right and left banks, and comprises 35 neighborhoods and 5 villages. Economic life in this commune is essentially dominated by trade and craft activities.\u0026nbsp;(Figure 1)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. Type of study\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis was a descriptive and analytical cross-sectional study conducted over a two-month period from February 15, 2022 to April 15, 2022 in the Attecoube Lagune neighborhood.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3. Population \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study population was made up of residents of the Attecoube Lagune neighborhood, living between Banco Bay and Peace Boulevard.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResidents aged 18 and over who gave a positive opinion were included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNon-inclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePregnant women, sick people, non-consenting residents and anyone unable to perform a spirometry test were excluded from the study. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Sampling and sample size\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStarting from the center of the district, the right-hand side of the entrance to the Naval Training Center (CNI) was randomly selected as the starting point for data collection. We progressed in the direction of the interchange, with a sampling step equal to 2. We proceeded in this way to the right and left to visit the selected concessions. Within each concession, all individuals who met the inclusion criteria were exhaustively enrolled. \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe StatCalc program in Epi Info version 7.2.1 was used to calculate our minimum sample size. A minimum sample size of 153 was obtained. The elements used to calculate the minimum sample size were:\u003c/p\u003e\n\u003cp\u003e- Total population of Attecoube Lagune = 2,700 (Adjam\u0026eacute;-Plateau-Attecoube District Report, 2021).\u003c/p\u003e\n\u003cp\u003e- Prevalence of respiratory diseases in Attecoube = 12%. (District Adjam\u0026eacute;-Plateau-Attecoube report, 2021).\u003c/p\u003e\n\u003cp\u003e- Alpha risk = 5%.\u003c/p\u003e\n\u003cp\u003e- Confidence interval = 95%.\u003c/p\u003e\n\u003cp\u003eWith a 10% increase, our final sample size was 168 people.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5. Data collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs part of this study, three investigators, all students, received two days\u0026apos; classroom training on the research protocol and the various data collection tools and media. This training verified their understanding of research procedures (recruitment, consent and follow-up). In addition, a pre-test of the data collection form was carried out on February 10, 2022 in the Attecoube Sebroko\u0026nbsp;neighborhood, and enabled the various shortcomings to be corrected. In addition, spirometry was carried out by a team consisting of a nurse and a doctor, both specialists in functional exploration and highly experienced.\u003c/p\u003e\n\u003cp\u003eData collection took place in two phases. The first phase involved completing a questionnaire with each subject included in the study. The questionnaire collected information on socio-demographic characteristics, length of residence in the neighborhood, smoking habits, degree of exposure to pollution and health data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe respiratory symptoms sought were those suggestive of asthma or chronic obstructive pulmonary disease (dry cough, wheezing, dyspnea and chest tightness), and rhinoconjunctivitis (rhinorrhea, nasal obstruction, nasal tingling, sneezing, lacrimation, ocular redness).\u003c/p\u003e\n\u003cp\u003eThe second phase consisted in performing pulmonary auscultation and spirometry on each subject included in the study. Spirometry was performed using a Winspiro PRO6.5 MIR portable spirometer, followed by a reversibility test performed after inhalation of a 400 \u0026micro;g dose through an inhalation chamber. This test was carried out in accordance with the recommended guidelines of the American Thoracic Society (ATS) by two technicians (a nurse and a doctor) who were well trained to perform the said test.\u003c/p\u003e\n\u003cp\u003eThe parameters measured were: forced vital capacity (FVC) in liters, forced expiratory volume in one second (FEV1) in liters per second and the Tiffeneau ratio (FEV1/FVC) expressed as a percentage.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe pathological threshold was defined by a fall of more than 20% in FEV1, FVC, the pathological threshold of the Tiffeneau ratio was defined by a fall of more than 12% (FEV1/FVC \u0026lt; 80% of predicted) according to the ATS/ERS Criteria.\u003c/p\u003e\n\u003cp\u003eThe theoretical standard used is that of the African ethnic group incorporated into the spirometer software, which takes into account the subjects\u0026apos; sex, age, weight and height. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6. Operational definition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e- Obstructive ventilatory disorder (OVD) is defined by a FEV1/FVC ratio of less than 80% of predicted.\u003c/p\u003e\n\u003cp\u003eThe severity of the disorder is assessed on the basis of FEV1\u003c/p\u003e\n\u003cp\u003e- FEV1 \u0026gt; 80%: mild\u003c/p\u003e\n\u003cp\u003e- FEV1 50-80%: moderate\u003c/p\u003e\n\u003cp\u003e- FEV1 30-50%: severe\u003c/p\u003e\n\u003cp\u003e- FEV1 \u0026lt; 30%: very severe\u003c/p\u003e\n\u003cp\u003e- Reversibility of obstruction: gain in FEV1 of more than 12% (relative value) and 200ml (absolute value).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7. Data analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnivariate analysis was used to describe the variables: age, gender, height, weight, smoking, BMI, length of residence, occupation, level of education, level of exposure to pollution, respiratory symptoms (cough, dyspnea, wheezing, chest tightness) and family history of asthma.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe dependent variable: COPD (non-reversible TVO after beta 2 mimetic inhalation) was obtained from the results of spirometry performed on the inhabitants of Attecoube Lagune\u0026nbsp;neighborhood.\u003c/p\u003e\n\u003cp\u003eA bivariate analysis was used to search for possible links between the dependent variable (COPD) and the independent variables (age, sex, smoking status, length of residence, level of exposure, occupational activity and level of education).\u003c/p\u003e\n\u003cp\u003eIndependent variables with a significance level p \u0026le; 0.20 were included in the multivariate analysis.\u003c/p\u003e\n\u003cp\u003eMultiple logistic regression models were constructed to search for a link between the dependent variable and the selected independent variables. The top-down stepwise logistic regression method was adopted with (p \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e8. Ethical considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eVerbal and informed consent was obtained from the respondents, before proceeding with the interviews. The questionnaire was only administered once consent had been obtained. Anonymity and confidentiality were respected, and initials were used instead of names. Interviews were conducted in French or the local language, and in private locations to ensure confidentiality. Approval for the study was granted by the internal ethics committee of the National Institute of Public Health and the District Sanitaire Adjam\u0026eacute; -Plateau - Attecoube.\u0026nbsp;\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003e1. Socio-demographic characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study population comprised 103 women and 67 men, with a sex ratio (M/F) of 0.65. Mean age was 35.92 \u0026plusmn; 15.28 years. Over 41% of the population had secondary education or higher. Some 66% of residents had lived in the neighborhood for more than 10 years. Smoking status was found in 5.30% of residents, and obesity in over 26% of the population. \u003cem\u003e(Table 1\u003c/em\u003e)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 1\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e: Socio-demographic characteristics of Attecoube Lagune\u003c/em\u003e \u003cem\u003eneighborhood\u003c/em\u003e\u003cem\u003e\u0026nbsp;residents in 2022\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStaff (N) = 170\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMan\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e39.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWoman\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e60.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAge range\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e35 years \u0026le;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e56.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e35 years \u0026gt;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e43.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eStudy level\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNone\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e35.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e22.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecondary and higher\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e41.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTime of residence\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e10 years \u0026le;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e34.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e10 years \u0026gt;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e65.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTobacco status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e94.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; 5.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eBody mass index (BMI)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eunderweight\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e3.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal weight\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e48.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Overweight\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e21.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eObesity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e26.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. Prevalence of respiratory symptoms among residents of Attecoube Lagune\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cstrong\u003eneighborhood\u0026nbsp;in 2022\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe most frequent respiratory symptoms were, in order of importance, chest tightness (29.41%), dyspnea (28.82%), sneezing (22.94%) and cough (22.35%). \u003cem\u003e(Figure 2\u003c/em\u003e)\u003c/p\u003e\n\u003cp\u003eTwo socio-demographic characteristics were statistically associated with the occurrence of COPD in the population. The prevalence of COPD increased with age, but this difference was not statistically significant \u003cem\u003e(Table\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/em\u003e2\u003cem\u003e)\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable\u0026nbsp;2\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e:\u0026nbsp;\u003c/em\u003e\u003cem\u003eSocio-demographic characteristics of Attecoub\u0026eacute; Lagune neighbourhood residents with COPD in 2022\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.607329842931936%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaracteristics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"41.18673647469459%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCOPD\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(n%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.62652705061082%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal (n%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.57940663176265%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"47.88135593220339%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"52.11864406779661%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"83.44947735191637%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.550522648083625%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.09\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e100 (62.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e3 (33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e103 (60.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e61 (37.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e6 (66.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e67 (39.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"83.44947735191637%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.550522648083625%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.47\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOthers\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e95 (59.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e6 (66.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e101 (59.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTraders\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e66 (40.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e3 (33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e69 (40.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"83.44947735191637%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of exposition to air pollution\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.550522648083625%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.62\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eweak\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e37 (22.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e1 (11.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e38 (22.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eaverage\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e64 (39.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e3 (33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e67 (39.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003estrong\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e60 (37.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e5 (55.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e65 (38.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"83.44947735191637%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoker\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.550522648083625%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.13\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e151 (39.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e7 (77.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e158 (92.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e10 (6.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e2 (22.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e12 (7.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"83.44947735191637%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.550522648083625%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.048\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSingles\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e147 (91.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e6 (66.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e153 (90.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarried\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e14 (8.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e3 (33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e17 (10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"83.44947735191637%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody mass index (BMI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.550522648083625%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.67\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnderweight\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e6 (3.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e6 (3.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e79 (49.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e4 (44.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e83 (48.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverweight\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e35 (21.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e1 (11.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e36 (21.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eObesity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e41 (25.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e4 (44.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e45 (26.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge range (Years)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.607329842931936%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e18-30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.720767888307154%\" valign=\"top\"\u003e\n \u003cp\u003e77 (47.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.465968586387433%\" valign=\"top\"\u003e\n \u003cp\u003e2 (22.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.62652705061082%\" valign=\"top\"\u003e\n \u003cp\u003e79 (46.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.57940663176265%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.265\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e30-45\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e45 (27.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e3 (33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e48 (28.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.497907949790793%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;\u003cstrong\u003e45\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.640167364016737%\" valign=\"top\"\u003e\n \u003cp\u003e39 (24.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.732217573221757%\" valign=\"top\"\u003e\n \u003cp\u003e4 (44.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.12970711297071%\" valign=\"top\"\u003e\n \u003cp\u003e43 (25.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe prevalence of COPD in the Attecoube Lagune\u003cem\u003e\u0026nbsp;\u003c/em\u003eneighborhood population was estimated at 5.29%. \u003cem\u003e(Figure 3)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Risk factors for COPD in Attecoube Lagune\u003cem\u003e\u0026nbsp;\u003c/em\u003eneighborhood\u0026nbsp;in 2022\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMultivariate logistic regression revealed a risk factor for COPD that was smoking status [OR: 7.06; IC95%:1.00 - 10, 60; p \u0026lt; 0.05].\u003c/p\u003e\n\u003cp\u003eSmokers in the neighborhood were 7.06 times more likely to develop COPD than non-smokers. Exposure level was not associated with COPD \u003cem\u003e(table 3\u003c/em\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTableau 3:\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eRisk factors for COPD in Attecoube lagoon\u003c/em\u003e\u003cem\u003e\u0026nbsp;neighborhood in 2022\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCOPD\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;risk factors \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIC95%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAge range\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e[18-30, years]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e[30-45 years]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e0.22 \u0026ndash; 10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026gt; \u0026nbsp;0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt; 45 ans\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e2.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e0.33 \u0026ndash; 18.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026gt; 0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eLevel of exposure\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeak\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAverage\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e0.12 \u0026ndash; 13.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt; 0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrong\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e2.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e0.28 \u0026ndash;14.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt; 0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eMarital status\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSingle\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarried\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e5.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e0.96 \u0026ndash; 18.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt; 0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTime of residence\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt; 10 years\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026le; 10 years\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e0.12 \u0026ndash; 3.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt; 0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSmoker\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.6517571884984%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.731629392971247%\" valign=\"top\"\u003e\n \u003cp\u003e7.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.08626198083067%\" valign=\"top\"\u003e\n \u003cp\u003e1.00 \u0026ndash; 10.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.53035143769968%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt; 0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eChronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Almost 90% of COPD deaths occur in low- and middle-income countries [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. It is often a neglected disease in these countries. Moreover, COPD prevalence studies are rare in sub-Saharan Africa [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The aim of this study was to determine the prevalence of COPD and associated factors in order to prevent it in the population of Attecoube Lagune neighborhood in Abidjan.\u003c/p\u003e \u003cp\u003eTo our knowledge, this community-based study of COPD using spirometry is one of the first of its kind in C\u0026ocirc;te d'Ivoire.\u003c/p\u003e \u003cp\u003eCOPD generally occurs in smokers from the age of 40. As a result, most studies choose this age as the reference point. However, apart from tobacco, certain factors are likely to induce this condition. In fact, local practices related to COPD may involve a younger population than in Western contexts [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In Africa, for example, exposure to biomass fuels can lead to a high involvement of young subjects in COPD. In fact, just as tobacco smoke is the main risk factor for COPD in developed countries, domestic smoke from biomass combustion is an important risk factor for COPD in developing countries [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn our study, we chose the age of 18 instead of 40. This choice was justified by the fact that the majority of the population of the Attecoube Lagune neighborhood worked in small trades and had no stable income. Consequently, they generally used biomass for cooking. This choice is also justified by the fact that the age of majority in C\u0026ocirc;te d'Ivoire is 18. Our choice is similar to that of a study in Cameroon, which adopted 19 as the reference age [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe prevalence of COPD was estimated at 5.29% among Attecoube Lagune neighborhood residents. It was low, but higher than that obtained in the Cameroon community study, estimated at 2.9% [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], which adopted an age of 19 years, similar to our choice. The difference in prevalence observed could be explained by the definition of COPD adopted in each study. In the present study, the definition of COPD was based on the fixed FEV1/FVC ratio. Whereas in the Cameroon study, COPD was defined as a FEV1/FVC ratio\u0026thinsp;\u0026lt;\u0026thinsp;defined GLI - LLN. In studies using the fixed FEV1/FVC ratio definition, an overestimation of COPD prevalence was observed due to physiological decline with age.\u003c/p\u003e \u003cp\u003eStudies based on the fixed FEV1/FVC ratio carried out in Malawi, Tanzania, Ethiopia and Uganda reported prevalences of 17.8% [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], 17.5% [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], 16.2% [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] and 13.6% [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] respectively. The prevalence of our study was very low compared with those of these studies. The difference in prevalence observed between these studies and ours could be due to variations in the study population, sample size and methodology [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn our study, the sample size of 170 was very small compared with 734 in Ethiopia [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], 869 in Tanzania [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] and 588 in Uganda [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In Uganda, the prevalence of smoking was 36%, well above the prevalence in our study (7.06%). In the Ethiopian, Tanzanian and Malawian studies, the high use of biomass in poorly ventilated dwellings was reported. The combined action of all these factors could explain this marked difference in prevalence.\u003c/p\u003e \u003cp\u003eIn contrast, studies based on a defined FEV1/FVC\u0026thinsp;\u0026lt;\u0026thinsp;GLI - LLN ratio revealed low prevalences such as those by Pefura.Y et al (4%) in 2016 in Tanzania [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], Kayongo et al (6.22%) in 2017 in Uganda [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe prevalence of COPD can vary considerably depending on whether the definition adopted is based on the use of spirometry or not [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn some cases, case definitions were based on the British Medical Research Council (BMRC) questionnaire for chronic bronchitis, in which there was an affirmative response to the definition of \"daily productive cough for at least three consecutive months for more than two consecutive years\", and on a previous diagnosis of COPD by a physician [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Two meta-analyses of 13 African studies revealed that prevalences obtained with spirometry were higher than those obtained on the basis of symptoms [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The mean prevalence of COPD in symptom-defined cases was estimated at 4%, while those defined by spirometry had a mean prevalence of 13.4% [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. This could be justified by the fact that only spirometry could objectively diagnose bronchial obstruction. However, some providers did not always position spirometry as first-line treatment, given its non-routine availability [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. This situation confirms the underestimation of COPD in Africa.\u003c/p\u003e \u003cp\u003eIn our study, the prevalence of COPD increased with age. In fact, the prevalences were estimated at 2.53%, 6.25% and 9.30% respectively in the age groups [18yrs \u0026minus;\u0026thinsp;30yrs], ]30yrs \u0026minus;\u0026thinsp;45yrs] and over 45 years. However, this difference was not significant. This variation in COPD with age has been observed in other studies [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The prevalence of COPD tended to increase with age, and old age was considered a risk factor for developing COPD [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The association of COPD with old age can be attributed to greater exposure to risk factors and a physiological decline in lung function that appears around the age of 30 to 40 [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn terms of factors, smoking residents were 7.06 times more likely to develop COPD (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) than non-smoking residents. Indeed, active smoking is the main risk factor for COPD [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The prevalence of smoking in our study was estimated at 7.06%. This prevalence was higher than that of active smoking (5.66%) obtained in the study by TETCHI et al. (2022) carried out in a general population and involving a population ranging in age from 20 to 79 years [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eLevel of exposure to air pollution was not associated with COPD in our study. This could be justified by the fact that air quality was not actually measured. These are subjective data from the questionnaire administered at the surveys.\u003c/p\u003e \u003cp\u003eThe main limitation of this study was the absence of air quality measurement. The main strength of this study was the performance of baseline spirometry and beta 2 mimetic testing on all enrolled residents of Attecoube Lagune neighborhood. This is the very first community-based COPD study to use spirometry. Future studies are needed to better characterize this chronic respiratory condition, which appears to be poorly understood and neglected.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eChronic obstructive pulmonary disease (COPD) is a chronic, disabling respiratory illness. It is a non-curable but preventable condition. It is strongly associated with tobacco smoke. It would be desirable for the competent authorities in the municipality of Attecoube to undertake awareness-raising campaigns on tobacco in order to reduce the level of air pollution and offer their residents a better quality of life.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval was obtained from the Comit\u0026eacute; Scientifique Interne, Institut National de Sant\u0026eacute; Publique, Abidjan,\u0026nbsp;C\u0026ocirc;te d\u0026rsquo;Ivoire (N\u003csup\u003eo\u003c/sup\u003e 165).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA written informed consent was obtained from all participants in the study. Participation was voluntary and participants were informed of their right to withdraw from the study when they wished to do so. All the participants were aware of the study\u0026apos;s purpose, risks, and benefits.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Data were collected, managed, and analyzed in a way to ensure the confidentiality of study participants. All procedures performed in this study involving human participants were in accordance with the ethical standards of the national ethic review committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the first author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there are no conflicts of interest regarding the publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding received.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLLK wrote the study protocol and collected the data. He analyzed and interpreted the data then wrote the manuscript. EMLE made critical revision of the manuscript for important intellectual content.\u0026nbsp;ASW, OBY\u0026nbsp;and IT read and approved the final manuscript. Therefore, all the authors mentioned in this article contributed to the production of the work we are submitting, and the contents of the manuscript have never been published. They\u0026nbsp;agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was possible thanks to the leadership and management of the Directorate of the Public Health National Institute and the support of the Health District Adjame-Plateau-Attecoube of the Health Region Abidjan-1.\u003c/p\u003e\n\u003cp\u003eWe thank the management of the Director of the Health District Adjame-Plateau-Att\u0026eacute;coub\u0026eacute; who accepted that our study took place in this structure. We are particularly grateful young people from the Attecoube Lagune neighborhood who raised awareness and mobilized the population for this study. We would like to express our special thanks to the local youth president for her involvement and to the population of Attecoube Lagune neighborhood who allowed us to collect their data.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDia Kane Y, Thiam K, Diallo M, Nidaye EHM, Ciss\u0026eacute; MF, Mbaye FBR et al. Facteurs d\u0026rsquo;exacerbations aigu\u0026euml;s (EA) de broncho-pneumopathie chronique obstructive (BPCO) \u0026agrave; la clinique de pneumo-phtisiologie du centre hospitalier national universitaire (CHNU) de Fann, Dakar (S\u0026eacute;n\u0026eacute;gal) [Factors in acute exacerbations (AE) of chronic obstructive pulmonary disease (COPD) at the pneumo-phtisiology clinic of the Fann national university hospital, Dakar (Senegal)]. Rev Mal Respir. 2019;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRycroft CE, Heyes A, Lanza L, Becker K. Epidemiology of chronic obstructive pulmonary disease: A literature review. Int J COPD. 2012;7:457\u0026ndash;94.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAhmed R, Robinson R, Mortimer K. The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa. Malawi Med J. 2017;29(2):203\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrudhomme A. Maladies respiratoires: BPCO et asthme [Respiratory diseases: COPD and asthma]. In: Trait\u0026eacute; de sant\u0026eacute; publique. Lavoisier; 2016. p. 523. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.cairn.info/traite-de-sante-publique-9782257206794-page-523.htm\u003c/span\u003e\u003cspan address=\"http://www.cairn.info/traite-de-sante-publique-9782257206794-page-523.htm\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. Bronchopneumopathie chronique obstructive (BPOC) [Chronic obstructive pulmonary disease (COPD)]. 2023. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.who.int/mediacentre/factsheets/fs315/fr/\u003c/span\u003e\u003cspan address=\"http://www.who.int/mediacentre/factsheets/fs315/fr/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeriou F, Damen A, Ahmed Azi M, Moumeni A. La BPCO m\u0026eacute;connue [The misunderstood COPD]. Rev des Mal Respir Actual. 2022;14(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnon JC, Dembele R, Toh-Bi Y, Yeo L, Dje-Bi H, Achi V et al. Contribution pour am\u0026eacute;liorer la prise en charge de la BPCO en Afrique noire [Contribution to improving COPD management in Black Africa]. Rev des Mal Respir Actual. 2020;12(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAchi HV, Dje-Bi H, Yeo L, Tadet JON, N\u0026rsquo;Dhatz-Sanogo M. La BPCO dans le service de pneumologie du CHU de Bouak\u0026eacute; (RCI) [COPD in the pulmonology department of the University Hospital Center of Bouak\u0026eacute;, Ivory Coast]. Rev Mal Respir. 2017;34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. Bronchopneumopathie chronique obstructive (BPCO) [Chronic obstructive pulmonary disease (COPD)]. 2023. pp. 1\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/fr/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd\u003c/span\u003e\u003cspan address=\"https://www.who.int/fr/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWoldeamanuel GG, Mingude AB, Geta TG. Prevalence of chronic obstructive pulmonary disease (COPD) and its associated factors among adults in Abeshge District, Ethiopia: A cross sectional study. BMC Pulm Med. 2019;19(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMassongo M, Balkissou AD, Endale Mangamba L-M, Poka Mayap V, Ngah Komo ME, Nsounfon AW, et al. Chronic Obstructive Pulmonary Disease in Cameroon: Prevalence and Predictors\u0026mdash;A Multisetting Community-Based Study. Pulm Med. 2023;2023:1\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSiddharthan T, Pollard SL, Jackson P, Robertson NM, Wosu AC, Rahman N et al. Effectiveness of low-dose theophylline for the management of biomass-associated COPD (LODOT-BCOPD): study protocol for a randomized controlled trial. Trials. 2021;22(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMagitta NF, Walker RW, Apte KK, Shimwela MD, Mwaiselage JD, Sanga AA et al. Prevalence, risk factors and clinical correlates of COPD in a rural setting in Tanzania. Eur Respir J. 2018;51(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePefura-Yone EW, Kengne AP, Balkissou AD, Magne-Fotso CG, Ngo-Yonga M, Boulleys-Nana JR et al. Prevalence of obstructive lung disease in an African country using definitions from different international guidelines: A community based cross-sectional survey. BMC Res Notes. 2016;9(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKayongo A, Wosu AC, Naz T, Nassali F, Kalyesubula R, Kirenga B, et al. Chronic Obstructive Pulmonary Disease Prevalence and Associated Factors in a Setting of Well-Controlled HIV, A Cross-Sectional Study. COPD J Chronic Obstr Pulm Dis. 2020;17(3):297\u0026ndash;305.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAle BM, Ozoh OB, Gadanya MA, Li Y, Harhay MO, Adebiyi AO et al. Estimating the prevalence of COPD in an African country: evidence from southern Nigeria. J Glob Heal Rep. 2022;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMehrotra A, Oluwole AM, Gordon SB. The burden of COPD in Africa: A literature review and prospective survey of the availability of spirometry for COPD diagnosis in Africa. Volume 14. Tropical Medicine and International Health; 2009.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eL\u0026otilde;pez-Campos JL, Tan W, Soriano JB. Global burden of COPD. Volume 21. Respirology. Blackwell Publishing; 2016. pp. 14\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJarhyan P, Hutchinson A, Khaw D, Prabhakaran D, Mohan S. Prevalence of chronic obstructive pulmonary disease and chronic bronchitis in eight countries: a systematic review and meta-analysis. Bull World Health Organ. 2022;100(3):216\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRaherison C, Girodet PO. Epidemiology of COPD. Eur Respiratory Rev. 2009;18:213\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNugmanova D, Feshchenko Y, Iashyna L, Gyrina O, Malynovska K, Mammadbayov E et al. The prevalence, burden and risk factors associated with chronic obstructive pulmonary disease in Commonwealth of Independent States (Ukraine, Kazakhstan and Azerbaijan): Results of the CORE study. BMC Pulm Med. 2018;18(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKamal R, Srivastava AK, Kesavachandran CN. Meta-analysis approach to study the prevalence of chronic obstructive pulmonary disease among current, former and non-smokers. 2, Toxicol Rep. 2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAwokola BI, Amusa GA, Jewell CP, Okello G, Stobrink M, Finney LJ et al. Chronic obstructive pulmonary disease in sub-Saharan Africa. Int J Tuberc Lung Dis. 2022;26(3).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuillien A, Soumagne T, Dalphin JC, Degano B. COPD, airflow limitation and chronic bronchitis in farmers: A systematic review and meta-analysis. Occup Environ Med. 2019;76(1).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Chronic obstructive pulmonary disease, air pollution, Attecoube Lagune neighborhood, Abidjan, Cote d’Ivoire","lastPublishedDoi":"10.21203/rs.3.rs-4195386/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4195386/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e \u003cb\u003eIntroduction\u003c/b\u003e: Chronic obstructive pulmonary disease (COPD) is a severe, long-term, life-threatening respiratory illness. The aim of this study was to determine the prevalence of COPD and the factors associated with its prevention in the population of the Attecoube Lagune neighborhood of Abidjan, C\u0026ocirc;te d'Ivoire.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMaterial and methods\u003c/b\u003e: A descriptive and analytical cross-sectional study lasting 2 months was carried out in the Attecoube Lagune neighborhood of Abidjan in 2022. A questionnaire was used to collect information on sociodemographic, clinical and environmental characteristics. Baseline spirometry and a beta mimetic test were performed in all subjects surveyed to explore their respiratory function. Data analysis was performed using stata15.1 software.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResults\u003c/b\u003e: A total of 170 residents were surveyed, including 103 women and 67 men, with a sex ratio (M/F) of 0.65. Mean age was 35.92\u0026thinsp;\u0026plusmn;\u0026thinsp;15.28 years.\u003c/p\u003e \u003cp\u003eThe most frequent respiratory symptoms were chest tightness (29.41%), dyspnoea (28.82%) and cough (22.35%). The prevalence of COPD was 5.29% among Attecoube Lagune neighborhood residents. Tobacco smoke was strongly associated with COPD [OR\u0026thinsp;=\u0026thinsp;7, 06; IC95%: 1.00\u0026ndash;10.60; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05].\u003c/p\u003e \u003cp\u003e \u003cb\u003eConclusion\u003c/b\u003e: Chronic obstructive pulmonary disease (COPD) was strongly associated with tobacco smoke in Attecoube Lagune neighborhood. Awareness-raising campaigns on the dangers of tobacco and health promotion are needed in this commune.\u003c/p\u003e","manuscriptTitle":"Prevalence of Chronic Obstructive Pulmonary Disease in the Attecoube Lagune Neighborhood of Abidjan (Cote D'ivoire)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-04 13:42:35","doi":"10.21203/rs.3.rs-4195386/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6571411c-b60c-406a-8b49-3505854ed1de","owner":[],"postedDate":"April 4th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-09-17T14:38:58+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-04 13:42:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4195386","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4195386","identity":"rs-4195386","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}