Prevalence of benign prostatic hyperplasia among the adult general population of five Middle Eastern Countries: Results of the SNAPSHOT programme

Amr Noweir 1, Ashraf Abusamra 2, Abdelqader Al Zarooni 3, Murat Binbay 4, Adam Doble 5, Luqman Tariq 6, Fayaz Aziz 6, Abdelkader El Hasnaoui 6

Affiliations

doi: 10.1080/2090598X.2021.2010451

Abstract

Objectives: To present data on the prevalence of benign prostatic hyperplasia (BPH) in five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia, and the United Arab Emirates; the latter three forming a Gulf cluster).

Subjects and methods: The SNAPSHOT programme was a multi-country, cross-sectional epidemiological survey conducted by telephone in a random sample of the adult general population. Subjects were considered to have BPH if they fulfilled the screening criteria, based on diagnosis, symptoms, and treatments received in the past 12 months. Current prevalence (last 12 months) was estimated. Association with co-morbidities was investigated via multivariate logistic regressions. Quality of life (QoL) was assessed using the three-level EuroQol five-dimensions questionnaire (EQ-5D-3 L).

Results: In total, 5034 of 33,486 subjects enrolled in the SNAPSHOT programme were men aged ≥50 years. In all, 998 of these men fulfilled the BPH screening criteria. The overall prevalence of BPH ranged from 13.84% (95% confidence interval[CI] 12.3-15.4%) in Turkey, to 23.76% (95% CI 21.8-25.6%) in Egypt, and 23.79% (95% CI 21.2-26.3%) in the Gulf cluster. Co-morbidities occurred more frequently in men with BPH compared to the non-BPH population (57% vs 31%; P < 0.001). Principal co-morbidities associated with BPH were cardiovascular, renal, and diabetes mellitus (P < 0.001). The men with BPH reported significantly reduced QoL, with lower EQ-5D-3 L utility values (0.8) compared to the male general population (0.9) aged ≥50 years (P < 0.001).

Conclusion: The prevalence of BPH in these five Middle Eastern countries ranges from 13.84% to 23.79%. BPH has a negative impact on QoL and is associated with high levels of co-morbid diseases, indicating a need to better understand the management of the disease to reduce the impact on healthcare systems.

Keywords: Benign prostatic hyperplasia; co-morbidity; middle east; prevalence; quality of life; snapshot.

Conflict of interest statement

Abdelkader El Hasnaoui and Fayaz Aziz are employees of and shareholders in GSK, which funded the SNAPSHOT programme. At the time of the work on this publication, Luqman Tariq was an employee of and shareholder in GSK. Adam Doble is a director of Foxymed, a medical communication and consultancy company, which participated in the design of the programme and the interpretation of the results on behalf of GSK. The authors declare to have no further conflict of interest.

Figures

Figure 1. Screening criteria for BPH. (a) Screening questionnaire, (b) Screening algorithm used to determine which subjects are classified as diagnosed and/or treated BPH and LUTS suggestive of BPH.

Figure 1. Screening criteria for BPH. (a) Screening questionnaire, (b) Screening algorithm used to determine which subjects are classified as diagnosed and/or treated BPH and LUTS suggestive of BPH.

Figure 1. Screening criteria for BPH. (a) Screening questionnaire, (b) Screening algorithm used to determine which subjects are classified as diagnosed and/or treated BPH and LUTS suggestive of BPH.

Figure 1. Screening criteria for BPH. (a) Screening questionnaire, (b) Screening algorithm used to determine which subjects are classified as diagnosed and/or treated BPH and LUTS suggestive of BPH.

Figure 2. Overall prevalence of BPH by region. Prevalence of BPH (% [95% CI]) by region across the countries studied *P value (chi-square test); Egypt: A = Greater Cairo/North Egypt, B = Canal/other, C = Upper Egypt. Kuwait: A = Western Kuwait, B = Eastern Kuwait. UAE: A = East UAE, B = Abu Dhabi. Saudi Arabia: A = Western Saudi Arabia, B = Central Saudi Arabia, C = Eastern Saudi Arabia. Turkey: A = Marmara, B = Aegean, C = Black Sea, D = Central Anatolia, E = Mediterranean, F = Eastern Anatolia, G = South-eastern Anatolia. show full caption

Figure 2. Overall prevalence of BPH by region. Prevalence of BPH (% [95% CI]) by region across the countries studied *P value (chi-square test); Egypt: A = Greater Cairo/North Egypt, B = Canal/other, C = Upper Egypt. Kuwait: A = Western Kuwait, B = Eastern Kuwait. UAE: A = East UAE, B = Abu Dhabi. Saudi Arabia: A = Western Saudi Arabia, B = Central Saudi Arabia, C = Eastern Saudi Arabia. Turkey: A = Marmara, B = Aegean, C = Black Sea, D = Central Anatolia, E = Mediterranean, F = Eastern Anatolia, G = South-eastern Anatolia. show full caption

Figure 3. Multivariate regression analysis investigating the association between BPH and co-morbidities. BPH population (609 subjects) vs non-BPH population (4036 subjects.

Figure 3. Multivariate regression analysis investigating the association between BPH and co-morbidities. BPH population (609 subjects) vs non-BPH population (4036 subjects.

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