The incidence and clinical pattern of chronic obstructive pulmonary disease (COPD) in Ilorin, Nigeria

Background: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality in most countries. Few data exist on the pattern of COPD in Sub Saharan Africa. Objectives: This study aimed at reviewing the incidence and clinical pattern of COPD managed at the University of Ilorin Teaching Hospital (UITH) Ilorin, Nigeria over a decade. Methods: We carried out a retrospective study of patients who had a clinical diagnosis of COPD from January 2001 to December 2010. The medical records of the cases were carefully reviewed, clinical information extracted and the data analysed using computer software. Results: A total of 308 patients with clinical diagnosis of COPD were managed over period of 10 years and there was seven folds increase in the annual number of cases. The mean age of the patients was 66.1 ± 11.7 years and the male to female ratio was 4:1. COPD was more common among aged 60 -69 years, farmers, lower socioeconomic class, and those with only primary school education. The commonest presentations were chronic cough (85.2%), chronic expectoration of sputum (75.0%), breathlessness (77.9%) and wheezing (55.5%). Majority had a mixed pattern of chronic bronchitis and emphysema. Almost 70% of patients had a history of cigarette smoking with a median pack years of 10 years (0.2-45). Hypertension (31.5%) and biventricular failure (26%) were the most common co-morbidities. One hundred and eighty seven (60.7%) were managed as in-patients with an in- hospital mortality rate of 26.2%. Conclusion: The incidence of COPD is on the increase; therefore, concerted effort should be made to increase its awareness of this multi-systemic, under-recognised condition and risk factors in our society.