Guidance to the applicability of the Global Lung Initiative spirometry reference equations for South African populations

摘要

To the Editor: The lack of appropriate reference data for assessment of respiratory function in African populations and its implications for correct diagnosis and management of respiratory disease are longstanding concerns. The Global Lung Initiative 2012 (GLI2012) has the largest data set that provides guidance for spirometry reference equations across all ages for diverse populations across the world.[1] Until recently, the major limitation to its use in Africa was the lack of data from black African populations. A similar limitation applies to other currently used equations, and it is the reason for current recommendations for ethnic corrections, although the latter are not broadly validated, particularly in paediatric and adolescent populations. The only contribution of African population data to the GLI data set is from North Africa, where the ethnic background of the population was categorised as ‘Caucasian’ in the data set. The limitations of the recommendation from the North African population were also noted as being inappropriate compared with local previously derived Tunisian reference equations.[2] The challenges associated with lack of data from healthy populations in Africa are linked to multiple factors, some of which are lack of access to resources, technical expertise and equipment to collect large data sets of healthy African populations.