Chronic Obstructive Pulmonary Disease awareness in the adult African population: A RACE Africa study

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Résumé

Introduction: The burden of chronic obstructive pulmonary disease (COPD) is increasing in sub-Saharan Africa (SSA). Low awareness contributes to under diagnosis, delayed presentation for care, and poor outcomes.
Aim: To evaluate COPD awareness and knowledge of its symptoms and risk factors among adults in the seven African cities participating in the Raising COPD Awareness in Africa (RACE Africa) project.
Methods: A cross-sectional community-based survey was conducted in Nigeria (Lagos, Port Harcourt, Katsina), Ethiopia (Addis Ababa), Cameroon (Douala), Rwanda (Kigali), and Burkina Faso (Ouagadougou). A structured questionnaire was used to assess the awareness of COPD, asthma and HIV respectively, including awareness of their risk factors and symptoms. We used logistic regression to explore the factors associated with COPD awareness. Following the survey, we distributed educational materials in the participating communities and more broadly using social media.
Results: There were 7,327 participants (median age 35 years; 52.3% male) and 26.2% had heard of COPD, with large variation across sites. Awareness of tobacco smoking as a risk factor was reported in 7.3%, while 58.9% did not know any cause. Only 6.6% and 5.6% recognized cough and breathlessness, respectively, as COPD symptoms. In contrast, awareness of asthma and HIV exceeded 90% (Table 1). Tertiary education was independently associated with COPD awareness (AOR = 1.476, 95% CI: 1.196–1.822, p < 0.001).
Conclusion: COPD awareness in Africa is strikingly low compared to other chronic diseases such as asthma and HIV. These findings highlight the urgent need for large-scale, context-specific education to improve COPD literacy and guide policy prioritization.
Table 1: Summary of main results from the RACE Africa COPD awareness survey (N=7,327)
Variable Overall (%) Range across sites (%)
Heard of COPD 26.2 6.2 – 55.4
Correctly identified lungs 34.2 19.8 – 48.7
Knew ≥1 risk factor 41.1 22.5 – 53.2
– Tobacco smoking 7.3 –
Knew ≥1 symptom 41.7 25.4 – 49.0
– Cough 6.6 –
– Breathlessness 5.6 –
Asthma awareness 94.4 >90 in all sites
HIV awareness 95.6 >90 in all sites
Tertiary education increased awareness AOR = 1.476, 95% CI: 1.196–1.822, p < 0.001 –

Mots-clés

COPD, Awareness, Risk factors, Africa, Community survey