Comparing pulmonary function reference equation performance in evaluating abnormal spirometry in post-pneumonia ugandan adults

SESSION TITLE: Obstructive Lung Disease Posters 4 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Current ATS/ERS-recommended Global Lung Initiative (GLI) spirometric multiethnic reference equations do not include sub-Saharan Africa populations. In addition, ATS/ERS recommend the use of race-specific equations. However, because GLI equations for Black race are derived from a US-based sample of African Americans, their applicability to people living in Africa is uncertain. We evaluated the effects of using different reference equations on estimates of spirometric abnormalities and prediction of symptom burden in Ugandan adults. METHODS: Inflammation, Aging, Microbes and Obstructive Lung Disease (I AM OLD) is an ongoing study of HIV positive and negative adults in Kampala, Uganda presenting with acute pneumonia, who are followed longitudinally for changes in lung function after resolution of pneumonia. Spirometry was performed using an ndd Easy on-PC or EasyOne Pro. This is a cross-sectional analysis of the participants’ first ATS/ERS-compliant post-bronchodilator spirometry wherein %predicted and lower limit of normal (LLN) values were calculated using GLI-African American (GLI-AA), GLI-other, GLI-global, Hankinson, Musafiri (Rwanda 2013), Mengesha (Ethiopia 1985), and Bashir (Sudan 2010) reference equations. Associations of lung function estimates and respiratory symptom burden assessed by the COPD Assessment Test and St. George’s Respiratory Questionnaire were examined using gamma regression. RESULTS: Among 392 participants, mean age was 32 years, 44% were female, 40% HIV positive, and 79% post-TB. Prevalence of spirometric obstruction (FEV1/FVC更多