Noncommunicable Lung Disease in Sub-Saharan Africa. A Community-based Cross-Sectional Study of Adults in Urban Malawi

Barriers to Understanding the Epidemiology of Noncommunicable Lung Disease in Sub-Saharan Africa

“…Several results from the study by Meghji and colleagues warrant discussion in the context of existing data from other countries from sSA (13). Among urban Malawian participants who provided acceptable spirometric measurements, the prevalence of airway obstruction rates using a fixed ratio of FEV 1 /FVC , 70% was 4.3% (males) and 4.1% (females), with airway reversibility present in 4.2% of the cohort.…”

“…In conclusion, the work by Meghji and colleagues demonstrates the operational challenges to conducting high-quality NCLD research in a low-resource urban sSA setting (13). The authors' success in conducting a standardized BOLD study protocol highlights the positive and continued influence of the BOLD initiative in guiding comparable and population-based research data in sSA (14,16).…”

“…67-76), provides an informative and needed contribution (13). The authors are to be commended for their efforts to recruit a large study sample from this resource-poor setting and to collect and report data that aligned with the standards of the Burden of Obstructive Lung Disease (BOLD) initiative (14).…”

“…To estimate the prevalence of moderate-to-severe obstruction and spirometric restriction, Meghji and colleagues used and compared two distinct populations as reference values (13). In the first analysis, they applied age-, sex-, and height-standardized predicted values from the third survey wave of the National Health and Nutrition Examination Survey (NHANES III), derived from Caucasians in the United States (13).…”

“…In the first analysis, they applied age-, sex-, and height-standardized predicted values from the third survey wave of the National Health and Nutrition Examination Survey (NHANES III), derived from Caucasians in the United States (13). In the second analysis, they used locally derived reference ranges from nonsmoking, asymptomatic participants in the study (13). The use of different reference ranges limitedly altered the prevalence estimates of moderate-to-severe obstruction (NHANES = 3.6%; locally derived = 2.3%).…”