eprintid: 10196067
rev_number: 9
eprint_status: archive
userid: 699
dir: disk0/10/19/60/67
datestamp: 2024-08-22 10:27:27
lastmod: 2024-08-22 10:27:27
status_changed: 2024-08-22 10:27:27
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Siddharthan, Trishul
creators_name: Grealis, Kyle
creators_name: Robertson, Nicole M
creators_name: Lu, Min
creators_name: Liu, Sibei
creators_name: Pollard, Suzanne L
creators_name: Hossen, Shakir
creators_name: Jackson, Peter
creators_name: Rykiel, Natalie A
creators_name: Wosu, Adaeze C
creators_name: Flores-Flores, Oscar
creators_name: Quaderi, Shumonta A
creators_name: Alupo, Patricia
creators_name: Kirenga, Bruce
creators_name: Ricciardi, Federico
creators_name: Barber, Julie A
creators_name: Chandyo, Ram K
creators_name: Sharma, Arun K
creators_name: Das, Santa Kumar
creators_name: Shresthra, Laxman
creators_name: Miranda, J Jaime
creators_name: Checkley, William
creators_name: Hurst, John R
creators_name: GECo Study, Investigators
title: Assessing the prevalence and impact of preserved ratio impaired spirometry in low-income and middle-income countries: a post-hoc cross-sectional analysis
ispublished: pub
divisions: UCL
divisions: B02
divisions: B04
divisions: C10
divisions: C06
divisions: D17
divisions: F61
divisions: K71
keywords: Humans, Cross-Sectional Studies, Spirometry, Female, Male, Prevalence, Adult, Middle Aged, Developing Countries, Peru, Nepal, Uganda, Forced Expiratory Volume, Aged, Risk Factors, Young Adult
note: © 2024 The Author(s). Published by Elsevier Ltd. under a Creative Commons license (http://creativecommons.org/licenses/by/4.0/).
abstract: BACKGROUND: More than 90% of the morbidity and mortality from chronic respiratory disease occurs in low-income and middle-income countries (LMICs), with substantial economic impact. Preserved ratio impaired spirometry (PRISm) is a prevalent lung function abnormality associated with increased mortality in high-income countries. We aimed to conduct a post-hoc analysis of a cross-sectional study to assess the prevalence of, the risk factors for, and the impact of PRISm in three diverse LMIC settings. METHODS: We recruited a random, age-stratified and sex-stratified sample of the population in semi-urban Bhaktapur, Nepal; urban Lima, Peru; and rural Nakaseke, Uganda. Quality-assured post-bronchodilator spirometry was performed to American Thoracic Society standards and PRISm was defined as a forced expiratory volume in one second (FEV1) of less than 80% predicted with a FEV1/forced vital capacity ratio of 0·70 or more. We used t tests and χ2 analyses to assess the relationships between demographic, biometric, and comorbidity variables with PRISm. Multivariable logistic models with random intercept by site were used to estimate odds ratios (ORs) with 95% CIs. FINDINGS: 10 664 participants were included in the analysis, with a mean (SD) age of 56·3 (11·7) years and an equal distribution by sex. The prevalence of PRISm was 2·5% in Peru, 9·1% in Nepal, and 16·0% in Uganda. In multivariable analysis, younger age (OR for each decile of age 0·87, 95% CI 0·82-0·92) and being female (1·37, 1·18-1·58) were associated with increased odds of having PRISm. Biomass exposure was not consistently associated with PRISm across sites. Individuals with PRISm had impairment in respiratory-related quality of life as measured by the St George's Respiratory Questionnaire (OR by decile 1·18, 95% CI 1·10-1·25). INTERPRETATION: The prevalence of PRISm is heterogeneous across LMIC settings and associated with age, female sex, and biomass exposure, a common exposure in LMICs. A diagnosis of PRISm was associated with worse health status when compared with those with normal lung function. Health systems in LMICs should focus on all spirometric abnormalities as opposed to obstruction alone, given the disease burden, reduced quality of life, and size of the undiagnosed population at risk. FUNDING: Medical Research Council.
date: 2024-09
date_type: published
publisher: Elsevier BV
official_url: http://dx.doi.org/10.1016/s2214-109x(24)00233-x
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 2306487
doi: 10.1016/S2214-109X(24)00233-X
medium: Print
pii: S2214-109X(24)00233-X
lyricists_name: Barber, Julie
lyricists_name: Hurst, John
lyricists_id: JBARB68
lyricists_id: JHURS15
actors_name: Hurst, John
actors_id: JHURS15
actors_role: owner
full_text_status: public
publication: The Lancet Global Health
volume: 12
number: 9
pagerange: e1498-e1505
event_location: England
citation:        Siddharthan, Trishul;    Grealis, Kyle;    Robertson, Nicole M;    Lu, Min;    Liu, Sibei;    Pollard, Suzanne L;    Hossen, Shakir;                                                                     ... GECo Study, Investigators; + view all <#>        Siddharthan, Trishul;  Grealis, Kyle;  Robertson, Nicole M;  Lu, Min;  Liu, Sibei;  Pollard, Suzanne L;  Hossen, Shakir;  Jackson, Peter;  Rykiel, Natalie A;  Wosu, Adaeze C;  Flores-Flores, Oscar;  Quaderi, Shumonta A;  Alupo, Patricia;  Kirenga, Bruce;  Ricciardi, Federico;  Barber, Julie A;  Chandyo, Ram K;  Sharma, Arun K;  Das, Santa Kumar;  Shresthra, Laxman;  Miranda, J Jaime;  Checkley, William;  Hurst, John R;  GECo Study, Investigators;   - view fewer <#>    (2024)    Assessing the prevalence and impact of preserved ratio impaired spirometry in low-income and middle-income countries: a post-hoc cross-sectional analysis.                   The Lancet Global Health , 12  (9)   e1498-e1505.    10.1016/S2214-109X(24)00233-X <https://doi.org/10.1016/S2214-109X%2824%2900233-X>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10196067/3/Hurst_Assessing%20the%20prevalence%20and%20impact%20of%20preserved%20ratio%20impaired%20spirometry%20in%20low-income%20and%20middle-income%20countries_VoR.pdf