An urgent need for African spirometry reference equations: The Paediatric and Adult African Spirometry study

R. Masekela, G. L. Hall, S. Stanojevic, B. Sartorius, R. MacGinty, H. Benn Saad, Y. Trabelsi, F. Messan, M. Arigliani, A. Ketfi, Diane M. Gray

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: The GLI2012 (Global Lung Initiative 2012) has provided the largest data set to date for multiethnic 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. ME T HODS : 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. RESULT S : 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. CONCLUS ION: 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.

Original languageEnglish
Pages (from-to)952-958
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume23
Issue number8
DOIs
Publication statusPublished - 1 Aug 2019

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Spirometry
Forced Expiratory Volume
Pediatrics
Vital Capacity
Lung
Northern Africa
Namibia
Population
Central Africa
Eastern Africa
Africa South of the Sahara
African Americans
Reference Values

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Masekela, R. ; Hall, G. L. ; Stanojevic, S. ; Sartorius, B. ; MacGinty, R. ; Benn Saad, H. ; Trabelsi, Y. ; Messan, F. ; Arigliani, M. ; Ketfi, A. ; Gray, Diane M. / An urgent need for African spirometry reference equations : The Paediatric and Adult African Spirometry study. In: International Journal of Tuberculosis and Lung Disease. 2019 ; Vol. 23, No. 8. pp. 952-958.
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title = "An urgent need for African spirometry reference equations: The Paediatric and Adult African Spirometry study",
abstract = "BACKGROUND: The GLI2012 (Global Lung Initiative 2012) has provided the largest data set to date for multiethnic 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. ME T HODS : 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. RESULT S : 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. CONCLUS ION: 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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author = "R. Masekela and Hall, {G. L.} and S. Stanojevic and B. Sartorius and R. MacGinty and {Benn Saad}, H. and Y. Trabelsi and F. Messan and M. Arigliani and A. Ketfi and Gray, {Diane M.}",
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Masekela, R, Hall, GL, Stanojevic, S, Sartorius, B, MacGinty, R, Benn Saad, H, Trabelsi, Y, Messan, F, Arigliani, M, Ketfi, A & Gray, DM 2019, 'An urgent need for African spirometry reference equations: The Paediatric and Adult African Spirometry study' International Journal of Tuberculosis and Lung Disease, vol. 23, no. 8, pp. 952-958. https://doi.org/10.5588/ijtld.18.0442

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.; Gray, Diane M.

In: International Journal of Tuberculosis and Lung Disease, Vol. 23, No. 8, 01.08.2019, p. 952-958.

Research output: Contribution to journalArticle

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T1 - An urgent need for African spirometry reference equations

T2 - The Paediatric and Adult African Spirometry study

AU - Masekela, R.

AU - Hall, G. L.

AU - Stanojevic, S.

AU - Sartorius, B.

AU - MacGinty, R.

AU - Benn Saad, H.

AU - Trabelsi, Y.

AU - Messan, F.

AU - Arigliani, M.

AU - Ketfi, A.

AU - Gray, Diane M.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - BACKGROUND: The GLI2012 (Global Lung Initiative 2012) has provided the largest data set to date for multiethnic 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. ME T HODS : 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. RESULT S : 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. CONCLUS ION: 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.

AB - BACKGROUND: The GLI2012 (Global Lung Initiative 2012) has provided the largest data set to date for multiethnic 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. ME T HODS : 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. RESULT S : 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. CONCLUS ION: 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.

KW - Africa

KW - Global lung initiative

KW - Healthy

KW - Lung function

KW - Population

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DO - 10.5588/ijtld.18.0442

M3 - Article

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JO - International Journal of Tuberculosis & Lung Disease

JF - International Journal of Tuberculosis & Lung Disease

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