Prevalence and impacts of breathlessness in South Africa: an exploratory, cross-sectional population study.
8 affiliations
- 1College of Medicine and Public Health, Flinders University, Adelaide, Australia.
- 2Faculty of Health, University of Technology Sydney, Sydney, Australia.
- 3Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
- 4Centre for Health Policy and Management, Discipline of Public Health and Primary Care, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland.
- 5Wolfson Palliative Care Research Centre, University of Hull, Hull, UK.
- 6Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
- 7Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
- 8Division of Pulmonology and UCT Lung Institute, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Abstract
Background
Chronic breathlessness contributes substantially to the global health burden and healthcare use, yet data on its prevalence and impacts in lower-resource settings remain limited. We investigated the prevalence, self-reported underlying conditions, and impacts of breathlessness at the population level in South Africa.Methods
We conducted a cross-sectional online survey in English among community-dwelling adults aged 18 years or older. The sample was stratified by age, sex, and rurality to reflect the 2022 National Census. Self-reported data included sociodemographic characteristics; breathlessness, assessed using the modified Medical Research Council (mMRC) breathlessness scale; employment; activities of daily living, assessed using an item from the London Chest Activities of Daily Living; quality of life, assessed using the EQ-5D-5L and EQ visual analogue scale; and disability, assessed using the 12-item World Health Organization Disability Assessment Schedule 2.0. We analysed the weighted dataset using descriptive statistics.Results
We included 2,828 respondents with a mean age of 37.1 years (standard deviation = 12.4), of whom 52.3% were female. Clinically important breathlessness (mMRC ≥ 2) was reported by 189 respondents (6.7%), with a median duration of 3.1 years (interquartile range = 1.5-5.4). The most commonly reported attributions were lung conditions other than tuberculosis (23.8%), 'other' factors (16.4%), and anaemia (11.6%). Clinically important breathlessness was associated with poorer perceived health, lower quality of life, and higher total disability scores than mild (mMRC 1) or no breathlessness (mMRC 0). Mobility and participation were the most affected disability domains. Among respondents with an mMRC≥2, 64 (33.8%) reported an impact on employment, of whom 49 (76.6%) had ceased full-time work, while 171 (90.3%) respondents reported an impact on daily activities.Conclusions
We estimate that more than four million people in South Africa live with clinically important breathlessness. The symptom is associated with poorer quality of life, greater disability, reduced employment, and impaired function. The life-changing effects of this debilitating symptom among community-dwelling adults should be investigated in longitudinal studies to help inform clinical policy and practice.
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BibTeX
@article{kochovska2026prevalence,
title = {{Prevalence and impacts of breathlessness in South Africa: an exploratory, cross-sectional population study.}},
author = {Slavica Kochovska and Vanessa N Brunelli and Sungwon Chang and Irina Kinchin and Danny J Eckert and Joseph D Clark and Jacob Sandberg and Magnus Ekström and David C Currow and Richard N van Zyl-Smit},
journal = {Journal of global health},
year = {2026},
month = oct,
doi = {10.7189/jogh.16.04229},
url = {https://europepmc.org/article/MED/42852612},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prevalence and impacts of breathlessness in South Africa: an exploratory, cross-sectional population study.
AU - Slavica Kochovska
AU - Vanessa N Brunelli
AU - Sungwon Chang
AU - Irina Kinchin
AU - Danny J Eckert
AU - Joseph D Clark
AU - Jacob Sandberg
AU - Magnus Ekström
AU - David C Currow
AU - Richard N van Zyl-Smit
PY - 2026
DA - 2026/10/09
JO - Journal of global health
DO - 10.7189/jogh.16.04229
UR - https://europepmc.org/article/MED/42852612
AB - Background Chronic breathlessness contributes substantially to the global health burden and healthcare use, yet data on its prevalence and impacts in lower-resource settings remain limited. We investigated the prevalence, self-reported underlying conditions, and impacts of breathlessness at the population level in South Africa.Methods We conducted a cross-sectional online survey in English among community-dwelling adults aged 18 years or older. The sample was stratified by age, sex, and rurality to reflect the 2022 National Census. Self-reported data included sociodemographic characteristics; breathlessness, assessed using the modified Medical Research Council (mMRC) breathlessness scale; employment; activities of daily living, assessed using an item from the London Chest Activities of Daily Living; quality of life, assessed using the EQ-5D-5L and EQ visual analogue scale; and disability, assessed using the 12-item World Health Organization Disability Assessment Schedule 2.0. We analysed the weighted dataset using descriptive statistics.Results We included 2,828 respondents with a mean age of 37.1 years (standard deviation = 12.4), of whom 52.3% were female. Clinically important breathlessness (mMRC ≥ 2) was reported by 189 respondents (6.7%), with a median duration of 3.1 years (interquartile range = 1.5-5.4). The most commonly reported attributions were lung conditions other than tuberculosis (23.8%), 'other' factors (16.4%), and anaemia (11.6%). Clinically important breathlessness was associated with poorer perceived health, lower quality of life, and higher total disability scores than mild (mMRC 1) or no breathlessness (mMRC 0). Mobility and participation were the most affected disability domains. Among respondents with an mMRC≥2, 64 (33.8%) reported an impact on employment, of whom 49 (76.6%) had ceased full-time work, while 171 (90.3%) respondents reported an impact on daily activities.Conclusions We estimate that more than four million people in South Africa live with clinically important breathlessness. The symptom is associated with poorer quality of life, greater disability, reduced employment, and impaired function. The life-changing effects of this debilitating symptom among community-dwelling adults should be investigated in longitudinal studies to help inform clinical policy and practice.
SN - 2047-2978
SN - 2047-2986
ER -