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Open Access Association between chronic airflow obstruction and socio-economic position in Morocco: BOLD results

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BACKGROUND: Chronic obstructive lung disease (COPD) is the third most common cause of death in the world. Factors other than smoking, such as socio-economic status, could be involved in the development of COPD.

OBJECTIVE: To investigate the association between chronic airflow obstruction and socio-economic status in Morocco.

DESIGN: Questionnaires were administered and spirometry tests performed as part of the BOLD (Burden of Obstructive Lung Disease) Study carried out in Fez, Morocco. Socio-economic status was evaluated using a wealth score (0–10) based on household assets. The ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) was used to measure airflow obstruction.

RESULTS: A total of 760 subjects were included in the analysis. The mean age was 55.3 years (standard deviation [SD] 10.2); the average wealth score was 7.54 (SD 1.63). After controlling for other factors and potential confounders, FEV1/FVC increased by 0.4% (95%CI 0.01–0.78; P < 0.04) per unit increase in wealth score. Ageing, tobacco smoking, underweight, history of tuberculosis and asthma were also independently associated with a higher risk of airflow obstruction.

CONCLUSION: Our findings suggest that airflow obstruction is associated with poverty in Morocco. Further investigations are needed to better understand the mechanisms of this association.
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Keywords: BOLD study; Morocco; chronic obstructive lung disease; poverty

Document Type: Research Article

Affiliations: 1: Department of Epidemiology and Public Health, Faculty of Medicine of Fez 2: Pneumology Service, Centre Hospitalier Hassan II of Fez, University Sidi Mohamed Ben Abdellah, Fez, Morocco 3: National Heart & Lung Institute, Imperial College, London, UK

Publication date: February 1, 2020

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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.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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