Authors: Ehrlich R.I.¹; White N.²; Norman R.³; Laubscher R.³; Steyn K.³; Lombard C.³; Bradshaw D.³

Source: The International Journal of Tuberculosis and Lung Disease, Volume 8, Number 3, March 2004 , pp. 369-376(8)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: National household survey of adults in South Africa, a middle income country.

OBJECTIVE: To determine the prevalence and predictors of chronic bronchitis.

DESIGN: A stratified national probability sample of households was selected. All adults in the selected households were interviewed. Chronic bronchitis was defined as chronic productive cough. Socio-demographic predictors were wealth, education, race, age and urban residence. Personal and exposure variables included history of tuberculosis, domestic exposure to smoky fuels, occupational exposures, smoking and body mass index.

RESULTS: The overall prevalence of chronic bronchitis was 2.3% in men and 2.8% in women. The strongest predictor of chronic bronchitis was a history of tuberculosis (men, odds ratio [OR] 4.9; 95% confidence interval [CI] 2.6–9.2; women, OR 6.6; 95%CI 3.7–11.9). Other risk factors were smoking, occupational exposure (in men), domestic exposure to smoky fuel (in women) and (in univariate analysis only) being underweight. Wealth and particularly education were protective.

CONCLUSION: The pattern of chronic bronchitis in South Africa suggests a combination of risk factors that includes not only smoking but also tuberculosis, occupational exposures in men and domestic fuel exposure in women. Control of these risk factors requires public health action across a broad front. The protective role of education requires elucidation.

Keywords: chronic bronchitis; occupation; fuel; tobacco; developing countries

Document Type: Regular paper

Affiliations: 1: School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa 2: Respiratory Unit, School of Adult Clinical Medicine, University of Cape Town, Cape Town, South Africa 3: South African Medical Research Council, Cape Town, South Africa

Publication date: 2004-03-01

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• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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