The burden of chronic respiratory symptoms and respiratory functional limitations is underestimated in Africa. Few data are available on carbon monoxide (CO) poisoning in sub-Saharan Africa and existing data is derived from CO in ambient air, but not from biomarkers in the blood. Data from the Tanzanian Lung Health study, a cross-sectional study on lung health among outpatients and visitors to an urban as well as a rural hospital in Tanzania, was analyzed to describe respiratory symptoms and functional limitations. Saturation of peripheral blood with carbon monoxide (SpCO) was measured transcutaneously and non-invasively in participants using a modified pulse oxymeter indicative of CO poisoning. Univariate and multivariate analysis was performed. Nine hundred and ninety-seven participants were included in the analysis, the median age of participants was 46 years (49% male). 38% of participants reported some degree of chronic shortness of breath and 26% felt limited in their daily activities or at work by this symptom. The median SpCO was 7% (IQR 4–13, range 2–31%) among all participants without active smoking status (N = 808). Participants cooking with gas or electricity had the lowest SpCO (median 5%), followed by participants cooking with charcoal (median 7%). Cooking with wood, particularly using a stove, resulted in highest SpCO (median 11.5%). Participants from households where cooking takes place in a separate room had the lowest SpCO as compared to cooking outside or cooking in a shared room inside (6% vs. 9% vs.10.5%, p < 0.01). Sex or the activity of cooking itself was not associated with a difference in SpCO. Multivariate analysis confirmed cooking in a separate room (as compared to cooking outside) and living in a rural vs. urban setting as protective factors against high SpCO. The findings demonstrate a high burden of chronic respiratory symptoms which also cause socioeconomic impact. High levels of SpCO indicate a relevant burden of carbon monoxide poisoning in the local population. The level of CO in the blood is more dependent on shared exposure to sources of CO with the type of housing and type of cooking fuel as most relevant factors, and less on person-individual risk factors or activities.

中文翻译：

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坦桑尼亚与呼吸系统健康和一氧化碳中毒相关的症状和功能限制：一项横断面研究

在非洲，慢性呼吸道症状和呼吸功能限制的负担被低估了。关于撒哈拉以南非洲一氧化碳 (CO) 中毒的数据很少，现有数据来自环境空气中的 CO，但不是来自血液中的生物标志物。来自坦桑尼亚肺健康研究的数据是一项关于坦桑尼亚城市和乡村医院门诊患者和来访者肺部健康的横断面研究，用于描述呼吸系统症状和功能限制。使用指示一氧化碳中毒的改良脉搏血氧计经皮和无创地测量参与者的外周血一氧化碳 (SpCO) 饱和度。进行了单变量和多变量分析。分析中包括了 997 名参与者，参与者的中位年龄为 46 岁（49% 为男性）。38% 的参与者报告了某种程度的慢性呼吸急促，26% 的参与者感到日常活动或工作受到这种症状的限制。在所有没有主动吸烟状态的参与者（N = 808）中，SpCO 的中位数为 7%（IQR 4-13，范围 2-31%）。使用燃气或电力烹饪的参与者的 SpCO 最低（中位数 5%），其次是使用木炭烹饪的参与者（中位数 7%）。用木头烹饪，特别是使用炉子，导致 SpCO 最高（中位数 11.5%）。与在室外烹饪或在室内共用房间烹饪相比，在单独房间内烹饪的家庭参与者的 SpCO 最低（6% vs. 9% vs.10.5%，p < 0.01）。性别或烹饪活动本身与 SpCO 的差异无关。多变量分析证实，在单独的房间内烹饪（与在室外烹饪相比）和生活在农村与城市环境中是对抗高 SpCO 的保护因素。研究结果表明，慢性呼吸道症状的负担很重，这也会造成社会经济影响。高水平的 SpCO 表明当地人群存在相关的一氧化碳中毒负担。血液中的 CO 水平更多地取决于共同暴露于 CO 源，其中住房类型和烹饪燃料类型是最相关的因素，而较少取决于个人风险因素或活动。高水平的 SpCO 表明当地人群存在相关的一氧化碳中毒负担。血液中的 CO 水平更多地取决于共同暴露于 CO 源，其中住房类型和烹饪燃料类型是最相关的因素，而较少取决于个人风险因素或活动。高水平的 SpCO 表明当地人群存在相关的一氧化碳中毒负担。血液中的 CO 水平更多地取决于共同暴露于 CO 源，其中住房类型和烹饪燃料类型是最相关的因素，而较少取决于个人风险因素或活动。