Plymouth role in East Africa chronic lung disease study
Patients at a chronic lung disease rehabilitation centre in Kampala, Uganda

Researchers from Plymouth University have played a role in a study funded by the International Primary Care Respiratory Group (IPCRG) which has revealed the high prevalence of chronic lung disease in people aged 30 and over in a rural district of Uganda. 

This represents a potentially major problem for the health system where approximately 85% of the population lives in rural areas.

The study is published in The Lancet Global Health.

The study found that the average prevalence of chronic ling disease in people aged 30 and over was 16.2 per cent and the prevalence in people aged 30-39 was extremely high at 39 per cent. In this part of the world the whole family is exposed life-long to smoke from a combination of indoor biomass fuel smoke, kerosene lighting and tobacco smoke, and this starts when babies are in the womb.     

Yet there is very little knowledge amongst healthcare workers, policy-makers or the communities of the impact of smoke on their health, or as a way of explaining their symptoms of cough and wheeze.

“The findings demonstrate the value of integrating qualitative and quantitative research carried out by local teams so that they gain knowledge and commitment to finding solutions,” 

said Prof Niels Chavannes, Immediate Past President IPCRG and Leiden University Medical Center, author of the original FRESH AIR protocol that was initially tested in Vietnam. 

“Now we must test solutions.  The priority is to promote awareness of the harmful effects of smoke from tobacco, indoor biomass fuel from cooking and kerosene lighting amongst healthcare workers and policy makers.  We are starting with a grant from Global Bridges for education about tobacco dependence in the context of lung health, and are broadening to include all forms of smoke. We also need simple practical ventilation solutions and harm reduction measures such as energy-saving stoves and retained-heat cookers that the community chooses,” 

said Dr Frederik van Gemert, Principal Investigator and GP, supported by University of Groningen, Netherlands.

“We must provide education about behavioural change.  Public health and clinical researchers have to work together to improve knowledge of early detection, diagnosis and treatment of COPD and to enable the health system to reduce the current and future burden of chronic lung disease,”  

said Dr Bruce Kirenga, one of the contributors based at the University of Makerere, Uganda. 

Said Dr. Rupert Jones of Plymouth University: 

“These communities currently have no access to effective inhaled and stop smoking therapy, so as clinicians we have to find ways to test feasible treatments, for example rehabilitation programmes of education and exercise, as well as quit smoking and improved ventilation, and help make the case for access for all to effective treatments.“  

FRESH AIR is gaining ground as a movement that will provide comparable data and a global network committed to developing sustainable, acceptable and low cost interventions to improve communities’ lung health.  It is now being used in Kyrgyzstan using a grant from the European Lung Foundation, and will start shortly in slums in India.