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

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Biostatistics

Background:

• The Global Lung Initiative 2012 (GLI 2012) provides extensive spirometry reference equations but lacks sufficient data from African populations.
• Accurate spirometry interpretation relies on comparing individual lung function to ethnicity- and sex-appropriate reference values for diagnosing lung disorders.

Purpose of the Study:

• To systematically review spirometry data from African populations to assess the applicability of GLI 2012 reference equations.
• To evaluate the fit of GLI 2012 reference equations for different African sub-regions and ethnicities.

Main Methods:

• A systematic review of nine studies reporting spirometry results in 4750 healthy children and adults across North, South, East, West, and Central Africa.
• Collated spirometry data (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], and FEV1/FVC ratios) were analyzed using Z-scores against GLI 2012 reference equations.

Main Results:

• Sub-Saharan African populations (Southern, Central, East) showed a good fit with the GLI-African American reference equations.
• North African populations demonstrated the best fit with the GLI Caucasian reference equations.
• West African populations exhibited a poor fit with all tested GLI reference equations, highlighting regional variations.

Conclusions:

• The GLI 2012 spirometry reference values show potential for use in North and sub-Saharan African populations, with ethnic correction factors being crucial.
• Further research and data collection are needed to refine spirometry reference equations for diverse African populations, particularly West Africa.