Michele Arigliani1, Mario C Canciani1, Giovanni Mottini2, Michele Altomare3, Andrea Magnolato4, Sofia Vanda Loa Clemente5, Leon Tshilolo6, Paola Cogo1, Philip H Quanjer7,8. 1. 1 Department of Clinical and Experimental Medical Sciences, Unit of Pediatrics, University Hospital of Udine, Udine, Italy. 2. 2 International Health Cooperation Project, University Campus Bio-Medico, Rome, Italy. 3. 3 "Sapienza" University of Rome, Rome, Italy. 4. 4 University of Trieste, Trieste, Italy. 5. 5 Hospital Divina Providencia, Luanda, Angola. 6. 6 Service de Pédiatrie, Centre Hospitalier Monkole and Centre de Formation et d'Appui Sanitaire, Kinshasa, Democratic Republic of the Congo; and. 7. 7 Department of Pulmonary Diseases and. 8. 8 Department of Paediatrics-Pulmonary Diseases, Erasmus Medical Centre, Erasmus University, Rotterdam, the Netherlands.
Abstract
RATIONALE: Despite the high burden of respiratory disease, no spirometry reference values for African children are available. OBJECTIVES: Investigate whether the Global Lung Initiative (GLI-2012) reference values for spirometry are appropriate for children in sub-Saharan Africa and assess the impact of malnutrition on lung function. METHODS: Anthropometry and spirometry were obtained in children aged 6 to 12 years from urban and semiurban schools in three African countries. Spirometry z-scores were derived using the GLI-2012 prediction equations for African Americans. Thinness (body mass index z-score < -2) was a surrogate for malnutrition. Spirometry outcomes were compared with those of African American children from the third National Health and Nutrition Survey. MEASUREMENTS AND MAIN RESULTS: Spirometry data were analyzed from 1,082 schoolchildren (51% boys) aged 6.0 to 12.8 years in Angola (n = 306), Democratic Republic of the Congo (n = 377), and Madagascar (n = 399). GLI-2012 provided a good fit with mean (SD) z-scores of -0.11 (0.83) for FEV1, -0.08 (0.86) for FVC, and -0.07 (0.83) for FEV1/FVC. Because of low scatter, the fifth centile corresponded to -1.3 z-scores in boys and -1.5 z-scores in girls. Malnourished African children had a normal FEV1/FVC ratio but significant reductions of ∼0.5 z-scores (∼5%) in FEV1 and FVC compared with African American peers from the third National Health and Nutrition Survey. Children in Angola had the lowest, and those in Madagascar had the highest, zFEV1 and zFVC. CONCLUSIONS: The results of this study support the use of GLI-2012 reference values for schoolchildren in sub-Saharan Africa. Malnutrition affects body growth, leading to a proportionately smaller FEV1 and FVC without respiratory impairment, as shown by the normal FEV1/FVC ratio.
RATIONALE: Despite the high burden of respiratory disease, no spirometry reference values for African children are available. OBJECTIVES: Investigate whether the Global Lung Initiative (GLI-2012) reference values for spirometry are appropriate for children in sub-Saharan Africa and assess the impact of malnutrition on lung function. METHODS: Anthropometry and spirometry were obtained in children aged 6 to 12 years from urban and semiurban schools in three African countries. Spirometry z-scores were derived using the GLI-2012 prediction equations for African Americans. Thinness (body mass index z-score < -2) was a surrogate for malnutrition. Spirometry outcomes were compared with those of African American children from the third National Health and Nutrition Survey. MEASUREMENTS AND MAIN RESULTS: Spirometry data were analyzed from 1,082 schoolchildren (51% boys) aged 6.0 to 12.8 years in Angola (n = 306), Democratic Republic of the Congo (n = 377), and Madagascar (n = 399). GLI-2012 provided a good fit with mean (SD) z-scores of -0.11 (0.83) for FEV1, -0.08 (0.86) for FVC, and -0.07 (0.83) for FEV1/FVC. Because of low scatter, the fifth centile corresponded to -1.3 z-scores in boys and -1.5 z-scores in girls. Malnourished African children had a normal FEV1/FVC ratio but significant reductions of ∼0.5 z-scores (∼5%) in FEV1 and FVC compared with African American peers from the third National Health and Nutrition Survey. Children in Angola had the lowest, and those in Madagascar had the highest, zFEV1 and zFVC. CONCLUSIONS: The results of this study support the use of GLI-2012 reference values for schoolchildren in sub-Saharan Africa. Malnutrition affects body growth, leading to a proportionately smaller FEV1 and FVC without respiratory impairment, as shown by the normal FEV1/FVC ratio.
Authors: Sara-Jane Smith; Diane M Gray; Rae P MacGinty; Graham L Hall; Sanja Stanojevic; Reratilwe Mphahlele; Refiloe Masekela Journal: Am J Respir Crit Care Med Date: 2020-12-15 Impact factor: 21.405
Authors: Seyram Kaali; Darby W Jack; Rebecca K D Prah; Steven N Chillrud; Mohammed N Mujtaba; Patrick L Kinney; Theresa Tawiah; Qiang Yang; Felix B Oppong; Carlos F Gould; Musah Osei; Blair J Wylie; Oscar Agyei; Matthew S Perzanowski; Kwaku Poku Asante; Alison G Lee Journal: Pediatr Pulmonol Date: 2022-06-13
Authors: Jonathan Witonsky; Jennifer R Elhawary; Celeste Eng; José R Rodríguez-Santana; Luisa N Borrell; Esteban G Burchard Journal: Chest Date: 2022-01-13 Impact factor: 10.262
Authors: Rebeca Mozun; Cristina Ardura-Garcia; Eva S L Pedersen; Jakob Usemann; Florian Singer; Philipp Latzin; Alexander Moeller; Claudia E Kuehni Journal: ERJ Open Res Date: 2022-04-19
Authors: Brendan G Cooper; Janet Stocks; Graham L Hall; Bruce Culver; Irene Steenbruggen; Kim W Carter; Bruce Robert Thompson; Brian L Graham; Martin R Miller; Gregg Ruppel; John Henderson; Carlos A Vaz Fragoso; Sanja Stanojevic Journal: Breathe (Sheff) Date: 2017-09
Authors: Sarah Rylance; Jamie Rylance; Grace McHugh; Edith Majonga; Tsitsi Bandason; Hilda Mujuru; Kusum Nathoo; Sarah Rowland-Jones; Marc Y R Henrion; Victoria Simms; Rashida A Ferrand Journal: PLoS One Date: 2019-03-21 Impact factor: 3.240