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

Improving lung health in low-income and middle-income countries: from challenges to solutions

“…Specific challenges to accessing diagnostic tools, including spirometry and imaging, at the primary care level include the funding of these services, and training in how to perform tests, maintain quality control, and accurately interpret results. 137 Advances in the development of reliable and portable spirometry, ultrasound and chest x-ray equipment for community-based diagnosis may facilitate decentralisation, but services may prove more sustainable if accompanied by education and access to equipment maintenance services. 138 It is likely that more sophisticated diagnostics such as CT imaging, complex lung function testing, and bronchoscopy will remain the purview of tertiary centres in LMICs, but these tools are of value in the training and retention of specialist physicians, and building research capacity, such that limited investment in their centralised use may be of some benefit.…”

Advancing pediatric lung health in Africa: COVID-19 and beyond

“…[51] Recently, this reference has been validated for central African (Madagascar, Angola, and DRC), [52] North (Algeria), [53] and Southern Africa (South Africa) [54] pediatric populations, each showing a different GLI ethnic fit confirming that standards need to be population specific. [55] These papers have provided key data in providing evidence for reference standards for African children.…”

Review of the current use of global lung function initiative norms for spirometry (GLI-2012) and static lung volumes (GLI-2021) in Great Arab Maghreb (GAM) countries and steps required to improve their utilization

“…; z-score between −0.5 and +0.5 [ 5 ]) for FEV 1 (−0.55 ± 0.87), and FVC (−0.62 ± 0.86), and only mean z-score FEV 1 /FVC (=0.10 ± 0.73) was well within physiologically range considered to be irrelevant [ 28 ]. On the other hand, a multicenter African study recommended the use of the GLI-2012 spirometric norms (Caucasian group) in Tunisia [ 30 ]. In this study, Tunisia was represented by 2362 healthy subjects [1266 females, age median (IQR): 38.3 (12.0–50.0) years] [ 30 ].…”

“…On the other hand, a multicenter African study recommended the use of the GLI-2012 spirometric norms (Caucasian group) in Tunisia [ 30 ]. In this study, Tunisia was represented by 2362 healthy subjects [1266 females, age median (IQR): 38.3 (12.0–50.0) years] [ 30 ]. FEV 1 , FVC, and FEV 1 /FVC z-scores were within the normal range, respectively, −0.12 ± 1.37, −0.26 ± 1.36, and 0.25 ± 1.11 [ 30 ].…”