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

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.

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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