Open AccessIncidence and predictors of COPD mortality in Uganda: A 2-year prospective cohort study
Author(s) -
Patricia Alupo,
Adaeze C. Wosu,
Abdallah Mahofa,
Levicatus Mugenyi,
Daniel Semakula,
Winceslaus Katagira,
Bruce Kirenga
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0246850
Subject(s) - medicine , copd , underweight , hazard ratio , mortality rate , incidence (geometry) , cohort study , proportional hazards model , asthma , cohort , risk of mortality , prospective cohort study , risk factor , confidence interval , overweight , obesity , physics , optics
Background Data is lacking on outcomes among COPD patients in sub-Saharan Africa. The objective of the study was to assess the incidence and predictors of mortality among COPD patients enrolled in the Uganda Registry for Asthma and COPD. Research question What is the Incidence and predictors of mortality among COPD patients in Uganda? Study design and methods Individuals with a diagnosis of COPD at six hospitals in Uganda were enrolled into the registry, and followed every six months. Mortality was ascertained through post-mortem reports and verbal autopsies. Mortality rates (MR), mortality rate ratios (MRR), and hazard ratios (HR) were computed to assess associations between socio-demographic, behavioural, and clinical characteristics at enrolment into the registry and mortality up to two years after. Results We enrolled 296 COPD patients. Median age was 60 years, and 51·3% were male. The overall mortality rate was 95·90 deaths/1000 person-years. COPD severity by post-bronchodilator FEV 1 was the strongest risk factor for mortality. Compared to stage 1, adjusted hazard ratios were as follows for stage 4: 9·86 (95%CI: 1·70–57·14, p = 0·011), stage 3: 6·16 (95%CI: 1·25–30·32, p = 0·025), and stage 2: 1·76 (95%CI: 0·33–9·48, p = 0·51). Underweight patients had a higher incidence of mortality compared to normal weight patients (MRR: 3 · 47 (95%CI: 1·45–8·31, p = 0·0026). Conclusion Among COPD patients in Uganda, two-year mortality is high, and disease severity at baseline was the strongest risk factor for mortality. Our findings suggest the need for early, accurate, diagnosis and management of COPD, to potentially improve survival.