Awareness of chronic obstructive pulmonary disease in the adult population of seven African cities: a comparative analysis with asthma and HIV from the RACE Africa study

Abstract

Background Low COPD awareness contributes to underdiagnosis, and poor outcomes. Despite the growing burden of COPD in Africa, population literacy is not well described. This study, conducted under the Raising COPD Awareness in Africa (RACE Africa) partnership project, aimed to evaluate COPD awareness and knowledge across five African countries. Methods A community-based survey was conducted between October 2023 and February 2024 in seven cities across five African countries: Nigeria, Ethiopia, Cameroon, Rwanda, and Burkina Faso. A structured questionnaire was used to evaluate COPD awareness (defined as having heard of the disease name ‘COPD' or its French equivalent ‘BPCO') as well as awareness of asthma and HIV. We used logistic regression to assess determinants. Findings There were 7327 participants (median age 35 years; 3825/7307 (52.3%) male) and 1911/7294 (26.2%) were aware of COPD. Only 532/7307 (7.3%) reported tobacco smoking as a risk factor; 4300/7307 (58.9%) were unaware of any risks; and 485/7305 (6.6%) and 411/7305 (5.6%) recognized cough and breathlessness, respectively, as symptoms of COPD. In contrast, awareness of asthma and HIV exceeded 90%. Tertiary education and previous COPD diagnosis were independently associated with COPD awareness (AOR = 1.476, 95% CI: 1.196–1.822) and 19.91 (CI: 10.52–37.69) respectively. Interpretation COPD awareness in Africa is comparatively lower than that of asthma and HIV. There is an urgent need for large-scale, context-specific education to improve COPD literacy. Future studies should include rural and marginalised populations to provide a more comprehensive understanding of COPD awareness in Africa. Funding This study and the RACE Africa project was funded by the Global Initiative for Chronic Obstructive Lung Disease (GOLD).