Prevalence of chronic cough, its risk factors and population attributable risk in the Burden of Obstructive Lung Disease (BOLD) study: a multinational cross-sectional study
Hazim Abozid, Jaymini Patel, Peter Burney, Sylvia Hartl, Robab Breyer‐Kohansal, Kevin Mortimer, Asaad Ahmed Nafees, Mohammed Al Ghobain, Tobias Welte, Imed Harrabi, Meriam Denguezli, Li Cher Loh, Abdul Rashid, Þórarinn Gíslason, Cristina Bárbara, Joao Cardoso, Fátima Rodrigues, Terence Seemungal, Daniel Obaseki, Sanjay Juvekar, Stefanni Nonna Paraguas, Wan C. Tan, Frits M.E. Franssen, Filip Mejza, David M. Mannino, Christer Janson, Hamid Hacene Cherkaski, P A Mahesh, Hasan Hafizi, Sonia Buist, Parvaiz A. Koul, Asma El Sony, Marie‐Kathrin Breyer, Otto C. Burghuber, Emiel F.�M. Wouters, André F.S. Amaral, Hasan Hafizi, Anila Aliko, Donika Bardhi, Holta Tafa, Natasha Thanasi, Arian Mezini, Alma Teferici, Dafina Todri, Jolanda Nikolla, Rezarta Kazasi, Hamid Hacene Cherkaski, Amira Bengrait, Tabarek Haddad, Ibtissem Zgaoula, Maamar Ghit, Abdelhamid Roubhia, Soumaya Boudra, Feryal Atoui, Randa Yakoubi, Rachid Benali, Abdelghani Bencheikh, N Aït-Khaled, Christine Jenkins, Guy B. Marks, Taylor Bird, Paola Espinel, Kate Hardaker, Brett G. Toelle, Michael Studnicka, Torkil Dawes, Bernd Lamprecht, Lea Schirhofer, Akramul Islam, Syed Masud Ahmed, Shayla Islam, Qazi Shafayetul Islam, Mesbah-Ul-Haque, Tridib Roy Chowdhury, Sukantha Kumar Chatterjee, Dulal Mia, Shyamal C. Das, Mizanur Rahman, Nazrul Islam, Shahaz Uddin, Nurul Islam, Luiza Khatun, Monira Parvin, Abdul Awal Khan, Maidul Islam, Hervé Lawin, Arsène Kpangon, Karl Kpossou, G. Agodokpessi, Paul Ayélo, Benjamin Fayomi, Bertrand Mbatchou, Atongno Humphrey Ashu, Wan C. Tan, Wen Wang, Nanshan Zhong, Shengming Liu, Jiachun Lü, Pixin Ran, Dali Wang
Abstract
Background: Chronic cough is a common respiratory symptom with an impact on daily activities and quality of life. Global prevalence data are scarce and derive mainly from European and Asian countries and studies with outcomes other than chronic cough. In this study, we aimed to estimate the prevalence of chronic cough across a large number of study sites as well as to identify its main risk factors using a standardised protocol and definition. Methods: We analysed cross-sectional data from 33,983 adults (≥40 years), recruited between Jan 2, 2003 and Dec 26, 2016, in 41 sites (34 countries) from the Burden of Obstructive Lung Disease (BOLD) study. We estimated the prevalence of chronic cough for each site accounting for sampling design. To identify risk factors, we conducted multivariable logistic regression analysis within each site and then pooled estimates using random-effects meta-analysis. We also calculated the population attributable risk (PAR) associated with each of the identifed risk factors. Findings: The prevalence of chronic cough varied from 3% in India (rural Pune) to 24% in the United States of America (Lexington,KY). Chronic cough was more common among females, both current and passive smokers, those working in a dusty job, those with a history of tuberculosis, those who were obese, those with a low level of education and those with hypertension or airflow limitation. The most influential risk factors were current smoking and working in a dusty job. Interpretation: Our findings suggested that the prevalence of chronic cough varies widely across sites in different world regions. Cigarette smoking and exposure to dust in the workplace are its major risk factors. Funding: Wellcome Trust.