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Effect of Community-Based Respiratory Screening on Chronic Respiratory Disease Detection among Adults in Nigeria

Abstract

Chronic respiratory diseases remain an important public health concern among adults in Nigeria and include conditions such as asthma, chronic obstructive pulmonary disease, and other long-term respiratory disorders that may cause persistent symptoms, reduced physical capacity, impaired quality of life, and premature mortality. Adults may be exposed to several respiratory risk factors, including household air pollution, tobacco smoke, occupational dust and chemicals, outdoor air pollution, biomass fuel use, and recurrent respiratory infections. Many chronic respiratory diseases may remain undetected because symptoms can develop gradually or may be mistaken for temporary respiratory infections, resulting in delayed diagnosis and treatment. Early detection is essential for appropriate clinical assessment, treatment, lifestyle modification, exposure reduction, and long-term disease management. Community-based respiratory screening provides an opportunity to bring respiratory health assessment closer to adults through community outreach programmes, primary healthcare centres, mobile health services, workplaces, markets, and other community platforms. Screening may involve assessment of respiratory symptoms, medical and exposure history, peak flow measurement, spirometry where available, and referral for further clinical evaluation. However, inadequate screening coverage, limited access to diagnostic equipment, shortages of trained healthcare personnel, low awareness, financial barriers, and weak referral systems may limit the effectiveness of community-based respiratory screening programmes in Nigeria. Against this background, this study investigates the effect of community-based respiratory screening on chronic respiratory disease detection among adults in Nigeria. The study will be anchored on the Health Belief Model, Community Health Theory, and the Health Systems Framework. The Health Belief Model explains how adults' perceptions of susceptibility to chronic respiratory diseases, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in respiratory screening. Community Health Theory emphasizes the delivery of accessible health services through community structures and the involvement of communities in disease prevention, health promotion, and early detection activities. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as essential components of effective respiratory screening and healthcare programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based respiratory screening may influence chronic respiratory disease detection among adults in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adults aged 18 years and above residing in selected communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, households, and eligible adults. Community-based respiratory screening will be measured using indicators such as availability of screening services, screening coverage, frequency of community screening activities, accessibility of screening locations, number of adults screened, respiratory symptom assessment, exposure history assessment, peak flow measurement, spirometry where available, availability of trained healthcare personnel, screening equipment, respiratory health education, and referral arrangements. Chronic respiratory disease detection will be assessed using indicators such as abnormal respiratory assessment findings, persistent respiratory symptoms, suspected asthma, chronic obstructive pulmonary disease, other chronic respiratory conditions, abnormal lung function results where applicable, newly identified cases, confirmed diagnoses following appropriate clinical evaluation, referrals for further assessment, and linkage to appropriate treatment and follow-up care. Data will be collected using structured questionnaires, validated respiratory screening tools, community screening registers, lung function assessment records, healthcare facility records, laboratory or diagnostic reports where applicable, referral registers, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, respiratory symptoms, and patterns of chronic respiratory disease detection. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of community-based respiratory screening on chronic respiratory disease detection. Where appropriate, detection rates before and after implementation of community-based screening activities may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based respiratory screening has a significant positive effect on chronic respiratory disease detection among adults in Nigeria. Adults who participate in community-based respiratory screening are expected to have a higher likelihood of having previously undetected chronic respiratory conditions identified than adults without access to such services. Systematic assessment of respiratory symptoms, exposure history, and lung function may facilitate early identification of asthma, chronic obstructive pulmonary disease, and other chronic respiratory disorders. Early detection may provide opportunities for timely clinical assessment, appropriate treatment, exposure reduction, smoking cessation support, environmental interventions, and continued disease monitoring. Bringing respiratory screening services closer to adults may reduce geographical, financial, and time-related barriers and encourage individuals with persistent respiratory symptoms to seek appropriate care. Conversely, inadequate screening coverage, limited availability of spirometry and other diagnostic equipment, shortages of trained healthcare personnel, low awareness, financial constraints, and weak referral and follow-up systems may reduce the effectiveness of community-based respiratory screening. The study therefore expects accessible and well-organized community-based respiratory screening to contribute significantly to improved detection and early management of chronic respiratory diseases among adults in Nigeria. The study is expected to contribute to the literature on community-based respiratory screening, chronic respiratory disease detection, adult respiratory health, asthma, chronic obstructive pulmonary disease, environmental health, occupational health, preventive healthcare, community health services, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, respiratory healthcare providers, community health workers, occupational health practitioners, development partners, and policymakers regarding strategies for improving early detection of chronic respiratory diseases. The study will also provide evidence-based recommendations for expanding community-based respiratory screening programmes, improving access to respiratory assessment and lung function testing, increasing availability of trained healthcare personnel and screening equipment, strengthening respiratory health education, reducing exposure to tobacco smoke and household and occupational air pollutants, improving referral and follow-up systems, and integrating chronic respiratory disease screening into primary healthcare and community health programmes across Nigeria.

Keywords: Community-based respiratory screening, chronic respiratory disease detection, adults, asthma, chronic obstructive pulmonary disease, respiratory health, lung function screening, environmental health, preventive healthcare, community health services, Nigeria, public health.