• R I Ehrlich, N White, R Norman, R Laubscher, K Steyn, C Lombard, and D Bradshaw.
• School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. ehrlich@cormack.uct.ac.za
• Int. J. Tuberc. Lung Dis. 2004 Mar 1; 8 (3): 369-76.

SettingNational household survey of adults in South Africa, a middle income country.ObjectiveTo determine the prevalence and predictors of chronic bronchitis.DesignA stratified national probability sample of households was selected. All adults in the selected households were interviewed. Chronic bronchitis was defined as chronic productive cough. Socio-demographic predictors were wealth, education, race, age and urban residence. Personal and exposure variables included history of tuberculosis, domestic exposure to smoky fuels, occupational exposures, smoking and body mass index.ResultsThe overall prevalence of chronic bronchitis was 2.3% in men and 2.8% in women. The strongest predictor of chronic bronchitis was a history of tuberculosis (men, odds ratio [OR] 4.9; 95% confidence interval [CI] 2.6-9.2; women, OR 6.6; 95%CI 3.7-11.9). Other risk factors were smoking, occupational exposure (in men), domestic exposure to smoky fuel (in women) and (in univariate analysis only) being underweight. Wealth and particularly education were protective.ConclusionThe pattern of chronic bronchitis in South Africa suggests a combination of risk factors that includes not only smoking but also tuberculosis, occupational exposures in men and domestic fuel exposure in women. Control of these risk factors requires public health action across a broad front. The protective role of education requires elucidation.

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