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Int. J. Environ. Res. Public Health 2013, 10(12), 7257-7271; doi:10.3390/ijerph10127257

Prevalence of COPD and Tobacco Smoking in Tunisia — Results from the BOLD Study

1,†,* , 2
1 Laboratory of Physiology, Faculty of Medicine Ibn El Jazzar, Mohamed Karoui Avenue, Sousse 4000, Tunisia 2 National Heart and Lung Institute, Imperial College London, Emmanuel Kaye Building, 1 Manresa Road, London, SW3 6LR, UK 3 Department of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR 97239, USA 4 Department of Epidemiology, University Hospital Farhat Hached, Sousse 4000, Tunisia These authors contributed equally to this work. These authors contributed equally to this work.
* Author to whom correspondence should be addressed.
Received: 26 September 2013 / Revised: 2 December 2013 / Accepted: 9 December 2013 / Published: 17 December 2013
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In Tunisia, there is a paucity of population-based data on Chronic Obstructive Pulmonary Disease (COPD) prevalence. To address this problem, we estimated the prevalence of COPD following the Burden of Lung Disease Initiative. We surveyed 807 adults aged 40+ years and have collected information on respiratory history and symptoms, risk factors for COPD and quality of life. Post-bronchodilator spirometry was performed and COPD and its stages were defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Six hundred and sixty one (661) subjects were included in the final analysis. The prevalence of GOLD Stage I and II or higher COPD were 7.8% and 4.2%, respectively (Lower Limit of Normal modified stage I and II or higher COPD prevalence were 5.3% and 3.8%, respectively). COPD was more common in subjects aged 70+ years and in those with a BMI < 20 kg/m2. Prevalence of stage I+ COPD was 2.3% in <10 pack years smoked and 16.1% in 20+ pack years smoked. Only 3.5% of participants reported doctor-diagnosed COPD. In this Tunisian population, the prevalence of COPD is higher than reported before and higher than self-reported doctor-diagnosed COPD. In subjects with COPD, age is a much more powerful predictor of lung function than smoking.
Keywords: COPD; prevalence; smoking; Tunisia; BOLD COPD; prevalence; smoking; Tunisia; BOLD
This is an open access article distributed under the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Daldoul, H.; Denguezli, M.; Jithoo, A.; Gnatiuc, L.; Buist, S.; Burney, P.; Tabka, Z.; Harrabi, I. Prevalence of COPD and Tobacco Smoking in Tunisia — Results from the BOLD Study. Int. J. Environ. Res. Public Health 2013, 10, 7257-7271.

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