The outcome of an in-depth study funded by IPCRG and begun in 2011 has now been published, http://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(14)70337-7.pdf revealing the high prevalence of spirometry-defined COPD in people aged 30 and over in a rural district of Uganda, which represents a potentially major problem for the health system where approximately 85% of the population lives in rural areas.
“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 Viet Nam.
“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.” 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.” Dr Bruce Kirenga, one of the contributors based at the University of Makerere, Uganda.
“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.
Notes and acknowledgements
FRESH AIR Uganda was conducted under the auspices of the University Medical Centre Groningen (the Netherlands) in close collaboration with Makerere University (Uganda) and the Leiden University Medical Centre (the Netherlands).
It was funded by the International Primary Care Respiratory Group (United Kingdom), supported in part by an unrestricted grant from Mundipharma International Ltd.
The staff of the District Health Office and the healthcare workers of Masindi district were employed as the FRESH AIR survey team and made the survey possible.
Six hundred and nine participants from the local community took part; 95% providing spirometry readings of an acceptable standard to include in the survey.
For more information To speak to the Principal Investigator, Frederik van Gemert, GP from Harlingen, Netherlands, and researcher at the University of Groningen, University Medical Centre Groningen, Department of Primary Care, Groningen, Netherlands; email firstname.lastname@example.org
The International Primary Care Respiratory Group (IPCRG) is a charity registered in Scotland working internationally (SC No: 035056) and a company limited by guarantee (Company number 256268)
The IPCRG is the Respiratory Special Interest Group of WONCA Europe and an Organisation in Collaborative Relations with WONCA Global The IPCRG is the primary care representative on WHO-Global Alliance against Chronic Respiratory Diseases (GARD) Planning Executive Supporter of the NCD Alliance www.theipcrg.org