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Spirometry Assessments in Children With Sickle Cell Disease in Ghana
Baah Agyeiwah Birgit1, Ntim Amankwa Emmanuel1, Osei Eugenia2
1Department of Physiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Insights
Children with sickle cell disease (SCD) in Ghana show reduced lung function and restrictive spirometry patterns. Female gender and higher BMI z-scores were linked to lower odds of restrictive lung function.
Area of Science:
- Pediatric Pulmonology
- Hematology
- Public Health
Background:
- Pulmonary disease is a frequent complication in children with sickle cell disease (SCD), often leading to impaired lung function.
- This study focuses on understanding spirometry patterns and contributing factors to reduced lung function in Ghanaian children with SCD.
Purpose of the Study:
- To investigate spirometry patterns in Ghanaian children diagnosed with sickle cell disease (SCD).
- To identify factors associated with diminished lung function in this pediatric population.
Main Methods:
- A case-control study was conducted with children aged 6-16 years, comparing those with SCD to healthy controls.
- Data collected included demographics, socio-economic status, and clinical information, with spirometry performed using the GLI-Black reference equation.
- Logistic and linear regression analyses were employed to identify contributing factors.
Main Results:
- Children with SCD exhibited significantly lower anthropometric measurements and lung volumes compared to controls.
- Abnormal lung function was more prevalent in children with SCD (42%) than in controls (17.4%), with restrictive patterns being most common.
- Female gender and higher BMI z-scores were associated with a reduced likelihood of restrictive lung function.
Conclusions:
- The study highlights a high prevalence of reduced anthropometric measurements and restrictive spirometry abnormalities in Ghanaian children with SCD.
- Factors such as female gender and higher BMI z-scores appear to be protective against restrictive lung function patterns in children with SCD.
Background:
Pulmonary disease in children with SCD is common and heterogeneous and includes pulmonary function impairment. This study aimed to investigate spirometry patterns in Ghanaian children with SCD and factors that contribute to low lung function.
Methods:
A case-control study involving children aged 6-16 years with and without SCD was carried out at the Komfo Anokye Teaching Hospital. Demographic, socio-economic, and clinical information were collected. Spirometry was performed for both cases and controls at enrolment and interpreted based on the GLI-Black reference equation. Logistic and linear regression analyses were performed.
Results:
A total of 115 cases and 115 controls were recruited for the study. Children with SCD had significantly lower anthropometric measurements, lower lung volumes compared to the controls: median (IQR) BMI z-scores; cases vs controls, -0.5 (-1.3 to 0.3); versus -0.2 (-0.9 to 0.8) p = 0.01, mean z- scores for forced expiratory volume in 1 s (FEV1), cases vs controls, -1.0 (SD1.2) vs -0.4 (SD 1.2) z-score, (p < 0.001), mean z-scores for forced vital capacity (FVC z-scores), cases versus controls, -0.8 (SD1.2) z score vs -0.3 (SD 1.3) z-score, (p < 0.001). Abnormal lung function was significantly more common in cases than controls, 42% (n = 48) and 17.4% (n = 20) respectively. The lung function abnormalities noted were as follows: restrictive pattern, cases versus controls [24.3% (n = 28) vs 12.2% (n = 14)] (p < 0.001), obstructive pattern [14.8% (n = 17) versus 5.2% (n = 6)] (p < 0.001), mixed pattern [2.6% (n = 3) versus 0 (p < 0.001). Being female and having higher BMI z-scores were associated with significantly lower odds of having a restrictive lung function pattern compared to normal lung function, OR 0.31 (95% CI 0.16, 0.58) (p < 0.001).
Conclusion:
This study has demonstrated a predominance of low anthropometric measurements and restrictive abnormality on spirometry in children with SCD in Ghana. Females and those with higher BMI z-scores had significantly lower odds of having a restrictive lung function pattern compared to normal lung function.
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