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LETTER TO THE EDITOR
Year : 2020  |  Volume : 15  |  Issue : 1  |  Page : 45
Pulmonary dysfunction among adolescents and adults with sickle cell disease in Nigeria: Implications for monitoring


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Web Publication2-Jan-2020

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad
Iraq
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DOI: 10.4103/atm.ATM_283_19

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How to cite this article:
Al-Mendalawi MD. Pulmonary dysfunction among adolescents and adults with sickle cell disease in Nigeria: Implications for monitoring. Ann Thorac Med 2020;15:45

How to cite this URL:
Al-Mendalawi MD. Pulmonary dysfunction among adolescents and adults with sickle cell disease in Nigeria: Implications for monitoring. Ann Thorac Med [serial online] 2020 [cited 2020 Jan 25];15:45. Available from: http://www.thoracicmedicine.org/text.asp?2020/15/1/45/274708




Sir,

I refer to the interesting case–control study by Ozoh et al.[1] published in the October–December 2019 issue of the Annals of Thoracic Medicine. The authors nicely studied the frequency and pattern of spirometric abnormalities in a cohort of Nigerian adults with sickle cell anemia (SCA). They found that the median forced expiratory volume 1 (FEV1), forced vital capacity (FVC), and the FEV1/FVC were significantly lower in SCD as compared to controls (P = 0.000 in all instances). The frequency of abnormal pulmonary patterns was higher in SCD as compared to controls with abnormal spirometric pattern in 71% and 31.5% of participants with SCD and controls, respectively (P = 0.000). The restrictive pattern was predominant (48% vs. 23%), but obstructive (11.8% vs. 7.4%) and mixed patterns (11% vs. 0.9%) were also found among SCD versus controls.[1] The authors addressed few study limitations. I presume that the following methodological limitation could shadow more suspicions on the study results. The authors stated in the methodology that they referred to the Global Lung Function Initiative (GLI) reference equations[2] for the characterization of spirometric pattern. It is explicit that using population-specific spirometric standard could describe better the pulmonary function status than using a foreign population standard. Actually, GLI reference is old dated back to 2012 and it was constructed based on over 160,000 data points from 72 centers in 33 countries in collaboration with the European Respiratory Society global Lung function initiative.[2] It is not worthy to be specifically employed for Nigerian adult population. This is centered on the notion that applying prediction formula derived for other populations always overestimated the values for the African ethnic population.[3] Importantly, spirometric standards for healthy Nigerian adults have been already formulated to be employed in the clinical fields and researches institutions.[4] I wonder why Ozoh et al.[1] did not refer to that national standard in the study methodology. I suppose that if they employed that standard, more accurate results might be yielded. Despite the study limitations, the reported high burden of pulmonary dysfunction in the studied SCA cohort (71%)[1] is worrying. It requires regular monitoring of lung function to maintain pulmonary health status on one hand and improve the quality of life on the other.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Ozoh OB, Kalejaiye OO, Eromesele OE, Adelabu YA, Dede SK, Ogunlesi FO, et al. Pulmonary dysfunction among adolescents and adults with sickle cell disease in Nigeria: Implications for monitoring. Ann Thorac Med 2019;14:269-77.  Back to cited text no. 1
  [Full text]  
2.
Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: The global lung function 2012 equations. Eur Respir J 2012;40:1324-43.  Back to cited text no. 2
    
3.
Njoku CH, Anah CO. Reference values for peak expiratory flow rate in adults of African descent. Trop Doct 2004;34:135-40.  Back to cited text no. 3
    
4.
Fawibe AE, Odeigah LO, Saka MJ. Reference equations for spirometric indices from a sample of the general adult population in Nigeria. BMC Pulm Med 2017;17:48.  Back to cited text no. 4
    




 

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