COPD case finding in UAE

Background : Case-finding strategies to screen for chronic obstructive pulmonary disease (COPD) need to be implemented worldwide. Objective :To investigate the applicability of case finding strategy for COPD in UAE. Methods : a cross-sectional survey conducted in a convenience sample of 40-80 yrs. old in Dubai, UAE, and consecutive individuals were invited to answer a short sociodemographic questionnaire including current and past history of smoking cigarettes and other local products, (midwakh, shisha.), as well as to conduct pre-Bronchodilator(pre-BD) spirometry to identify airflow limitation (FEV1/FVC) <0.70) compatible with COPD, finally a measurement of exhaled carbon monoxide (CO) and % carboxyhaemoglobin (CO Hb). Results : From 577 participants, 525 (91.0%) conducted quality controlled pre-BD spirometry. 68% were male, with a mean age of 59 years, 17% UAE Nationals, and 24% reported smoking of some sorts. Overall, 68 (12.9%, 95% C.I. 10.3% to 16.1%) had airflow limitation compatible with COPD. In the bivariate analysis, only increasing age and previous occupational exposure to dust were associated with COPD (both p<0.05). In the multivariate analysis, there was a trend for those older, non-UAE nationals, less educated, and smokers to have COPD, but again only occupational exposure to dust remained statistically significant. Finally, CO and %CO Hb were not useful to help determining those with airflow limitation, with an area under the curve (AUC) of only 0.57. However, they were very useful to identify either smokers of cigarettes (AUC=0.94) or shisha (AUC=0.85). Conclusions : Case-finding by spirometry in a population sample of mainly young, non-UAE individuals without a history of smoking exposure produced a relatively low yield of COPD diagnosis.