A development study of pulmonary rehabilitation for patients with chronic lung disease in Uganda

Background: Chronic lung disease (CLD) is a growing burden in Uganda. There is no useful treatment, but sufferers have poor health status and often are stigmatised. We aimed to test feasibility of a pulmonary rehabilitation (PR) programme in Kampala, Uganda, and adapted traditional PR for patients with post-TB lung disease and COPD. Methods: In a development study, respiratory specialists, nurses and physiotherapists formed a PR team. The exercise regime was based on conventional PR; the education programme covered normal lungs, post TB damage and COPD including breathlessness, exercise, nutrition, smoking and drug treatments. Qualitative and quantitative assessment of the programme included recruitment, retention and outcome measures including exercise capacity and health status questionnaires. Results: In March 2015- December 2015, 4 groups were conducted. In total we screened 193 (Post-TB 113 and 80 COPD) patients, 72 were assessed 46 were suitable and 44 started rehab (17 male; mean age 44 years, range 17-83) with 42 (95%) completing and 39 followed 6 weeks after. Main outcomes in Table 1. Conclusion: PR is feasible and appears effective in CLD and post TB patients in Uganda, but an adequately powered controlled trial is needed to confirm this. PR offers a new and sustainable therapy for the neglected problem of chronic lung disease in low to middle income countries. This study provides patient and stakeholder feedback to inform design and implementation of a full trial planned for Zambia, Kenya and Tanzania.