An urgent need for African spirometry reference equations: The paediatric and adult African spirometry study

Masekela, R
Hall, G.L
Stanojevic, S
Sartorius, B
MacGinty, R
Benn Saad, H
Trabelsi, Y
Messan, F
Arigliani, M
Ketfi, A
... show 1 more
BACKGROUND: The GLI2012 (Global Lung Initiative 2012) has provided the largest data set to date for multi-ethnic spirometry reference equations; however, data on African populations are limited. In pulmonary function testing, diagnosis of lung disorder is based on comparing the individual's lung function to a reference appropriate for sex and ethnicity. METHODS: We conducted a systematic review of studies reporting spirometry results in healthy children and adults in Africa. Data from these studies were collated for Z-scores of forced expiratory volume in 1 sec (zFEV1), forced vital capacity (zFVC) and zFEV1/FVC compared to GLI reference equations. RESULTS: Nine studies, covering a total of 4750 individuals from North, South, East, West and Central Africa (52% were female), were reviewed. Marked differences were noted between individuals from North Africa and sub-Saharan Africa. The Southern zFEV1 (−0.12 ± 0.98), zFVC (−0.15 ± 0.98) and zFEV1/FVC (0.05 ± 0.89), Central zFEV1 (−0.16 ± 0.79), zFVC (−0.09 ± 0.83) and zFEV1/FVC (−0.17 ± 0.71) and East African zFEV1 (0.10 ± 0.88), zFVC (0.16 ± 0.85) and zFEV1/FVC (−0.10 ± 0.95) cohorts had an excellent fit with the GLI-African American. The West African showed a poor fit to all reference equations. The North African group showed the best fit for the GLI Caucasian zFEV1 (−0.12 ± 1.37), zFVC (−0.26 ± 1.36) and zFEV1/FVC (0.25 ± 1.11). The zFEV1/FVC ratios were stable across all the populations. CONCLUSION: Current evidence seems to support the use of GLI2012 reference values in North African and sub-Saharan African populations after taking into account ethnic correction factors.
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International Union Against Tuberculosis and Lung Disease
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Africa,Global lung initiative,Healthy,Lung function,Population
Masekela R, Hall GL, Stanojevic S, Sartorius B, MacGinty R, Saad HB, Trabelsi Y, Messan F, Arigliani M, Ketfi A, Gray D. An urgent need for African spirometry reference equations: the Paediatric and Adult African Spirometry study. Int J Tuberc Lung Dis. 2019 Aug 1;23(8):952-958. doi: 10.5588/ijtld.18.0442.
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