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Determinants of Restrictive Spirometric Pattern in a Sub-Saharan Urban Setting: A Cross-sectional Population-based

Eric Walter Pefura-Yone¹, Adamou Dodo Balkissou¹, Andre Pascal Kengne²

¹Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon; Pneumology Service, Yaounde Jamot Hospital, Yaounde, Cameroon.

The Open Respiratory Medicine Journal

|February 2, 2017

Abstract

Background:

Restrictive spirometric pattern is a risk factor for all-cause and cause-specific mortality.

Objective:

We assessed the prevalence of restrictive pattern and investigated its determinants in a major sub-Saharan Africa city.

Methods:

Participants were adults (≥ 19 years) who took part in a population-based survey in Yaounde (Cameroon) between December 2013 and April 2014. Restrictive pattern was based on a FVC below the lower limit of the normal (LLN) and a ratio forced expiratory volume in one second (FEV1)/FVC ≥ LLN (LLN-based restrictive pattern) or a FVC <80% and FEV1/FVC ≥ LLN (fixed cut-off based restrictive pattern). Determinants were investigated by logistic regressions.

Results:

In all, 1003 participants [514 (51.2%) women] with a mean age of 33.7 years were included. The prevalence of restrictive pattern was 18.8% (95%CI: 16.6-21.2) based on LLN and 15.0% (13.0-17.2) based on fixed cut-off. LLN-based restrictive pattern was mild in 148 (78.3%) subjects, moderate in 35 (18.5%) and severe in 6 (3.2%). Determinants of LLN-based restrictive pattern were age ≥ 60 years [adjusted odds ratio 2.90 (95%CI 1.46-5.77), p=0.002), history of pulmonary tuberculosis [3.81(1.42-10.20), p=0.008], prevalent heart diseases [3.81 (1.20-12.12), p=0.024] and underweight [5.15(1.30-20.39), p=0.020]. Determinants were largely similar with slightly different effect sizes for fixed cut-off based restrictive pattern.

Conclusion:

Restrictive pattern was very frequent in this city.

Clinical Implications:

These results enhance the needs to increase the efforts to prevent and control tuberculosis, cardiovascular diseases and underweight in this setting.

Keywords:

Africa Cameroon Low forced vital capacity Prevalence Pulmonary restriction Restrictive lung disease

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