Spirometric reference values for an East-African population.

BACKGROUND: Accurate interpretation of lung function testing requires appropriate reference values. Unfortunately, few African countries have produced spirometric reference values for their populations. OBJECTIVES: The present study was carried out in order to establish normal lung function values for subjects living in Rwanda, East Africa. METHODS: The study was conducted in Kigali, capital of Rwanda, and in the rural district of Huye in southern Rwanda. The variables studied were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow. Multiple regression analysis was performed using age, height, weight and BMI as independent variables to obtain predicted equations for both sexes. RESULTS: Predicted equations for normal lung functions were obtained from 740 healthy nonsmoking subjects; 394 were females and 346 were males. Minor differences in FEV1 and FVC were observed in comparison with other studies of Africans, African-Americans (difference in FEV1 and FVC of less than 5%), Chinese and Indians. When compared with selected studies from Caucasians and white Americans, our results for FEV1 and FVC were 9-12% and 16-18% lower in men and 12-23% and 17-28% lower in women, respectively. CONCLUSIONS: This study provides reference values for pulmonary function in a healthy, nonsmoking Rwandan population and enables comparisons to be made with other prediction equations from other populations. Spirometric reference values in our study were similar to those obtained in a study of black Americans by Hankinson et al.

Prevalence of atopy, asthma and COPD in an urban and a rural area of an African country.

UNLABELLED: The objectives of this study were to determine the prevalence of asthma, atopy and COPD in Rwanda and to identify risk factors. The survey was conducted in Kigali, the Capital of Rwanda, and in Huye District, a rural area located in southern Rwanda. METHODS: A total of 2138 subjects were invited to participate in the study.1920 individuals (90%) answered to questionnaires on respiratory symptoms and performed spirometry, 1824 had acceptable spirograms and performed skin-prick test. In case of airflow obstruction (defined as pre-bronchodilator ratio FEV(1)/FVC < LLN) a post bronchodilator spirometry was performed. Reversibility was defined as an increase in FEV(1) of 200 ml and 12% above baseline FEV(1) after inhalation of 400 mcg of salbutamol. RESULTS: The mean age was 38.3 years; 48.1% of participants were males and 51.9% females. Airflow obstruction was found in 256 participants (14%); 163(8.9%) subjects were asthmatics and 82 (4.5%) had COPD. COPD was found in 9.6% of participants aged 45 years and above. 484 subjects had positive skin-prick tests (26.5%); house dust mite and grass pollen mix were the main allergens. Risk factors for asthma were allergy, female gender and living in Kigali. COPD was associated with cigarette smoking, age and male sex. CONCLUSION: this is the first study which shows the prevalence of atopy, asthma and COPD in Rwanda. Asthma and COPD were respectively diagnosed in 8.9% and 4.5% of participants. COPD was diagnosed in 9.6% of subjects aged ≥ 45 years.The prevalence of asthma was higher in urban compared to rural area.