Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis

Nadia Al Wachami; Morad Guennouni; Younes Iderdar; Karima Boumendil; Maryem Arraji; Yassmine Mourajid; Fatima Zahra Bouchachi; Mohamed Barkaoui; Mohamed Lahbib Louerdi; Abderraouf Hilali; Mohamed Chahboune

doi:10.1186/s12889-024-17686-9

Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis

BMC Public Health. 2024 Jan 25;24(1):297. doi: 10.1186/s12889-024-17686-9.

Affiliations

¹ Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco. n.alwachami@uhp.ac.ma.
² Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco.
³ Higher School of Education and Training, Chouaîb Doukkali University of El Jadida, El Jadida, Morocco.
⁴ Higher Institute of Sport, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, 26000, Settat, Morocco.
⁵ Provincial delegation of health, 26000, Settat, Morocco.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a major public health problem. The present study aims to provide a global and regional estimate of the prevalence of COPD based on spirometry according to the two most widely used diagnostic criteria of COPD: fixed ratio (FR) and lower limit of normal (LLN).

Methods: We conducted a systematic review of the literature according to PRISMA guidelines. MEDLINE, Web of Sciences, and Scopus databases were searched to identify studies on the spirometry-based prevalence of COPD in individuals aged 40 years and older. The meta-analysis was performed using MedCalc 19 software.

Results: In total, 42 of the 3393 studies reviewed were eligible for inclusion. The overall prevalence of COPD in people aged 40 years and older was 12.64% (95% CI 10.75%-14.65%) and 7.38% (95% CI 5.47% - 9.55%) based on FR and LLN criteria, respectively. By gender, men had a higher prevalence of COPD compared to women (15.47%; 95% CI 12.22%-19.02% for men versus 8.79%; 95% CI 6.94%-10.82% for women). Using the LLN criteria, the prevalence of COPD in both sexes was almost identical (8.67%; 95% CI 8.44%- 8.90% for men and 8.00%; 95% CI 6.42% - 9.73% for women). We reported a high prevalence of COPD among smokers and the elderly by both definitions of airway obstruction. Regional prevalence estimates using the FR definition indicate that the highest COPD prevalence was recorded in the Americas and the lowest was recorded in the Eastern Mediterranean region. Using the LLN definition, the highest prevalence was recorded in the Southeast Asian region and the lowest prevalence was recorded in the American region. The most common COPD stage was stage II, with a prevalence of 50.46%. The results indicate a huge lack of prevalence data in the African and Eastern Mediterranean region. The results were given using a random-effect model due to the high heterogeneity between studies.

Conclusion: Results show that the prevalence of COPD differs according to the diagnostic criteria used. In addition, management and prevention strategies targeting risk factors for COPD are certainly needed to reduce the global burden of this chronic respiratory disease.

Keywords: Chronic obstructive pulmonary disease; Prevalence; Spirometry; meta-analysis.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Adult
Aged
Airway Obstruction*
Female
Forced Expiratory Volume
Humans
Male
Middle Aged
Prevalence
Pulmonary Disease, Chronic Obstructive*
Risk Factors
Spirometry / methods