Global Health Clinical Research Training Fellowship

A determination of spirometry reference equations in South African children

Improving the understanding of lung function in South African population groups

The study aimed to collect lung function results for healthy South Africans. There is historically very little data from Africa regarding lung function in healthy individuals. Equations used when interpreting spirometry rely on the Global Lung Function Initiative spirometry equations (GLI2012) – as endorsed by major international respiratory societies such as European Respiratory Society and American Thoracic Society. The GLI2012 were based on a very large dataset from 26 different countries and are also continuous from early childhood to old age. However, the GLI2012 taskforce acknowledged that there was a lack of data for certain ethnic groups and called for further studies. For example, no data from Sub-Saharan Africa was included. This project aimed to fill this evidence gap by collecting results of spirometry in healthy non-smoking individuals aged 5-95 years in South Africa. The data was collected in the provinces of KwaZulu-Natal and also in the Western Cape. Prior to this study there was no clear guidance for health workers across Africa regarding what spirometry reference equations to use. This was due to a lack of data in this region regarding the GLI2012 equations and specifically which equation would be most appropriate to use in this population. Following this study, the Pan-African Thoracic Society (PATS) have been able to endorse the use of the GLI2012 equations. We hope that this research will have therefore helped guide health care workers in South Africa and may also inform those working in Sub-Saharan Africa about which spirometry reference equation should be used when interpreting lung function in this population. This will have implications for the diagnosis, management and monitoring of lung disease. Ultimately this research will help to improve the understanding and management of the health of people in Southern Africa.

Biography

Sara-Jane Smith is a doctor working in London with ten years of clinical experience. She has a previous degree in Anthropology and a strong interest in global health and in reducing health inequalities. Following her medical training in the UK she worked in a rural hospital in KwaZulu-Natal, South Africa. She returned to South Africa to carry out the ISSF global health fellowship.