In sub-Saharan Africa, little is known about the damage to respiratory health caused by biomass (wood, charcoal or grass) smoke and tobacco smoke. We assessed the prevalence of chronic obstructive pulmonary disease (COPD) and related risk factors in a rural region of Uganda.

We undertook a prospective observational cross-sectional study in rural Masindi, Uganda. We randomly selected people above the age of 30 years from 30 villages. We trained local healthcare workers, asked validated questionnaires and administered breathing tests (spirometry) to participants. We defined COPD as FEV1:FVC less than the lower limit of normal. We calculated prevalence of COPD and tested its association with risk factors.

Between 13 April and 14 Aug 2012, we invited 620 people to participate, of whom 588 provided acceptable spirometry and were analysed.


  • 93 per cent were exposed to biomass smoke, many for all their lives. 44 per cent of men were current smokers and 24 per cent former smokers. 8 per cent of women were current smokers and 18 per cent former smokers.
  • Prevalence of COPD was 16 per cent and this was highest in people aged 19–30 years. COPD was associated with wheeze and being a former smoker.
  • Mean Clinical COPD Questionnaire score was 0·81, mean Medical Research Council dyspnoea score was 1·33; 30 per cent of 95 patients had had one or more exacerbations in the past 12 months.


International Primary Care Respiratory Group, €150,000.


van Gemert F, Kirenga BJ, Chavannes N, Kamya M, Luzige S, Musinguzi P, Turyagaruka J, Jones R, Tsiligianni I, Williams S, de Jong C, van der Molen T. Prevalence of COPD in sub-Saharan Africa: FRESH AIR Uganda survey. Lancet Glob Health 2015; 3: e44–51

Funding Organisations