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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

Abozid H 1 , Patel J 2 , Burney P 2 , Hartl S 3 , Breyer-Kohansal R 3 , Mortimer K 4 Show all authors , Nafees AA 5 , Al Ghobain M 6 , Welte T 7 , Harrabi I 8 , Denguezli M 9 , Loh LC 10 , Rashid A 10 , Gislason T 11 , Barbara C 12 , Cardoso J 13 , Rodrigues F 14 , Seemungal T 15 , Obaseki D 16 , Juvekar S 17 , Paraguas SN 18 , Tan WC 19 , Franssen FME 20 , Mejza F 21 , Mannino D 22 , Janson C 23 , Cherkaski HH 9 , Anand MP 24 , Hafizi H 25 , Buist S 26 , Koul PA 27 , El Sony A 28 , Breyer MK 1 , Burghuber OC 3 , Wouters EFM 3 , Amaral AFS 2 , BOLD Collaborative Research Group

Affiliations 

  • 1 Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria
  • 2 National Heart and Lung Institute, Imperial College London, London, UK
  • 3 Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
  • 4 University of Cambridge, Cambridge, UK
  • 5 Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
  • 6 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  • 7 Department of Respiratory Medicine/Infectious Disease, Member of the German Centre for Lung Research, Hannover School of Medicine, Germany
  • 8 Ibn El Jazzar Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
  • 9 Department of Pneumology, Faculty of Medicine Annaba, University Badji Mokhtar of Annaba, Annaba, Algeria
  • 10 Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Penang, Malaysia
  • 11 Faculty of Medicine, University of Iceland, Reykjavík, Iceland
  • 12 Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
  • 13 Pulmonology Department, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • 14 Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
  • 15 Faculty of Medical Sciences, University of West Indies, St Augustine, Trinidad and Tobago
  • 16 Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
  • 17 Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
  • 18 Philippine College of Chest Physicians, Manila, Philippines
  • 19 University of British Columbia Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada
  • 20 Maastricht University Medical Centre, Maastricht, the Netherlands
  • 21 Centre for Evidence Based Medicine, 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
  • 22 University of Kentucky, Lexington, KY, USA
  • 23 Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
  • 24 Department of Respiratory Medicine, JSS Medical College, JSSAHER, Mysuru, India
  • 25 Faculty of Medicine, Tirana University Hospital "Shefqet Ndroqi", Tirana, Albania
  • 26 Oregon Health & Science University, Portland, USA
  • 27 Department of Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
  • 28 Epi-Lab, Khartoum, Sudan
EClinicalMedicine, 2024 Feb;68:102423.
PMID: 38268532 DOI: 10.1016/j.eclinm.2024.102423

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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