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Global estimates suggest that Chronic Obstructive Pulmonary Disease (COPD) is emerging as a leading cause of death in developing countries but there are few spirometry-based general population data on its prevalence and risk factors in sub-Saharan Africa. We used the Burden of Obstructive Lung Disease (BOLD) protocol to select a representative sample of adults aged 40 years and above in Ile-Ife, Nigeria. All the participants underwent spirometry and provided information on smoking history, biomass and occupational exposures as well as diagnosed respiratory diseases and symptoms. Chronic Airflow Obstruction (CAO) was defined as the ratio of post-bronchodilator (BD) one second Forced Expiratory Volume (FEV1) to Forced Vital Capacity (FVC) below the lower limit of normal (LLN) of the population distribution for FEV1/FVC. The overall prevalence of obstruction (post-BD FEV1/FVC < LLN) was 7.7% (2.7% above LLN) using Global Lung Function Initiative (GLI) equations. It was associated with few respiratory symptoms; 0.3% reported a previous doctor-diagnosed chronic bronchitis, emphysema or COPD. Independent predictors included a lack of education (OR 2.5, 95% CI: 1.0, 6.4) and a diagnosis of either TB (OR 23.4, 95% CI: 2.0, 278.6) or asthma (OR 35.4, 95%CI: 4.9, 255.8). There was no association with the use of firewood or coal for cooking or heating. The vast majority of this population (89%) are never smokers. We conclude that the prevalence of CAO is low in Ile-Ife, Nigeria and unrelated to biomass exposure. The key independent predictors are poor education, and previous diagnosis of tuberculosis or asthma.

Background: Asthma continues to be an important cause of morbidity and mortality in developing countries. But, its burden among adult populations in university campuses is not well described., Method: Through a multistage cluster sampling of students and staff of the Obafemi Awolowo University, Ile-Ife, Nigeria, we obtained a representative sample, each for students and staff. We administered the European Community Respiratory Health Survey (ECRHS) screening questionnaire to all the respondents. A subgroup did a spirometry test and completed a detailed questionnaire. Asthma was considered "possible", if a respondent provided affirmative response to symptoms of "wheezing or whistling", "attack of shortness of breath", "diagnosed attack of asthma" in the last 12 months or "currently taking medicines for asthma"., Results: From population of 13,750 students and 1428 staff of the university, we systematically sampled 2750 (20%) students and all the staff. Amongst these, 2372 students and 455 staff completed the screening questionnaire. The mean age (SD) of the responders was 21.9 (3.2) and 46.1 (8.9) for students and staff and most of them were men; 58.6% and 65.9%, respectively. While an estimated 2.6% (95% CI: 1.7-3.5) of students had an asthma attack in the preceding 12 months, 14.5% (95% CI: 12.5-16.5) and 25.2% (95% CI: 22.8-27.7) reported shortness of breath and nocturnal cough, respectively. The staff population reported fewer symptoms. The proportion with "possible asthma" was 18.2% (95% CI: 16.0-20.4) for students and 8.0% (95% CI: 5.4-10.7) for staff., Conclusion: The prevalence of asthma is high among students and staff of Obafemi Awolowo University, Nigeria.

Objective: Lung function measurements performed several times daily are useful for the diagnosis of occupational asthma. Patient fabrication of hand-recorded charts can limit confidence in the results; this is overcome using electronic meters that log time and measurement. We have compared individual and meter differences in FEV1 and PEF recorded by hand and from meter logs using expert subjects on four data-logging spirometers with different methods of measurement and different quality control software., Methods: Eight workers in a respiratory physiology department were asked to record FEV1 and PEF 2-hourly from waking for 7 days using four electronic meters (Easyone, Micro DL, Vitalograph Diary card 2110 and Piko-1) in random order. Subjects hand-recorded the best FEV1 and PEF from each session, this was compared with the logged data., Results: Discordant measurements from individuals were lower for FEV1 than PEF and differed from 4.4-19.1% for FEV1 (mean 9.4%, p < 0.0001) and 6-23.3% for PEF (mean 12.6, p < 0.0001). There were also significant differences between meters for both variables (p < 0.0001). The magnitude of the differences in PEF was highest for the Easyone (34l/min) and lowest for the Vitalograph Diary card 2110 (14l/min) and varied significantly between meters (mean 22l/min, p = 0.002)., Conclusions: Differences between hand-recorded and logged measurements are unlikely to be due solely to patient fabrication and can be due to quality criteria or other unclear software requirements applied after the results are shown on the meter screen; they differ between meters. Whether the differences shown affect clinical outcome will require further investigation.

Objective: To explore the relationship between psychosocial factors and asthma., Methods: One hundred consecutive asthmatics were screened using the 30-item version of the General Health Questionnaire (GHQ-30), Present state examination (PSE) and a socio-demographic schedule incorporating psychosocial variables. Chi-squared test, student "t" test and discriminant analysis were used in analysis., Results: Among the asthmatics studied 36% had psychopathology. Psychosocial variables significantly associated with psychopathology include worrying, crying, fighting, anger, marital tension, and menstruation. The presence of multiple psychosocial variables was significantly associated with psychopathology., Conclusion: Psychosocial variables predict the presence of psychopathology.

Introduction: Asthma continues to cause increasing morbidity and mortality among young adults in the developing world. There is scarcity of data on the prevalence of asthma among young Nigerian adults., Methods: We studied the prevalence of asthma among students (15-35 years of age) of the Obafemi Awolowo University using a standardized questionnaire. One thousand self-administered questionnaires were distributed; 903 were retrieved and analyzed (469 males, 434 females). Symptoms indicative of asthma were cough, chest tightness at rest and on exposure to irritants, and the presence of nocturnal symptoms. Students with three or more symptoms or who had a diagnosis of asthma were considered probable asthmatics and those with one or two symptoms as suspected asthmatics. Students in any of these two categories were defined as symptomatic respondents., Results: The 12-month prevalence of wheeze, night waking with cough, and chest tightness in the morning was 9.0% (n = 81) 9.4% (n = 85) and 8.0% (n = 72), respectively. One hundred and twenty-seven respondents (14.1%) comprising 49 males (10.4%) and 78 females (17.9%) had probable asthma. The remaining symptomatic respondents consisting of 20 males (4.3%) and 16 females (3.9%) had suspected asthma. Of these, only 32.5% (53/163) had been previously diagnosed and 22.1% were on occasional inhaled bronchodilator treatment., Conclusion: These results indicate a relatively high prevalence of asthma among the students. A greater proportion of them had not been diagnosed and were not receiving proper treatment.

Background: The association between asthma and anxiety has been a subject of various studies in developed countries, but there has been little work done in this area in developing countries. The goal of this study is to determine whether asthmatics are more anxious than orthopaedic patients and healthy individuals., Method: Fifty consecutive asthmatics were assessed. All completed a sociodemographic questionnaire, the General Health Questionnaire (GHQ--30) and the State Trait Anxiety Inventory (STAI--1 and 2). Healthy individuals (30) and orthopaedic patients (30) were also recruited as controls; they also completed the GHQ and the STAI--1 and 2., Results: No significant difference was found in the sociodemographic variables such as age, sex, occupation, and marital status. The asthmatics had a mean GHQ score of 4.2 (SD+/-4.6) while orthopaedic and healthy control groups scored 1.6 (SD+/-1.8) and 2 (SD+/- 1.8), respectively. There was a significant difference in the mean score of the index population (Asthmatics) and the comparison groups (F=7.09, DF=2/107, P=0.004). With GHQ, cutoff point of > or =5.34% of asthmatics scored above 5 while 10% and 13.3% of the orthopaedic patients and healthy controls each scored > or =5. A significant difference was obtained in the mean scores on the STAI--1 questionnaire (F=4.6, DF=2/107, P=.012) indicating state anxiety whereas there was no significant difference on the STAI-2 questionnaire (F= 1.2, DF=2/107, P=0.31)., Conclusion: Although asthmatics have higher anxiety compared to controls, this is not an inherent problem or trait among them.