Pediatric Respirology and Critical Care Medicine

LETTER TO EDITOR
Year
: 2019  |  Volume : 3  |  Issue : 1  |  Page : 17-

Pulmonary function abnormalities in nigerian children with sickle cell anemia: Prevalence, pattern, and predictive factors


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

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, P. O. Box 55302, Baghdad Post Office, Baghdad
Iraq




How to cite this article:
Al-Mendalawi MD. Pulmonary function abnormalities in nigerian children with sickle cell anemia: Prevalence, pattern, and predictive factors.Pediatr Respirol Crit Care Med 2019;3:17-17


How to cite this URL:
Al-Mendalawi MD. Pulmonary function abnormalities in nigerian children with sickle cell anemia: Prevalence, pattern, and predictive factors. Pediatr Respirol Crit Care Med [serial online] 2019 [cited 2020 Apr 7 ];3:17-17
Available from: http://www.prccm.org/text.asp?2019/3/1/17/257928


Full Text



Sir,

It is worthy to comment on the interesting study by Kuti and Adegoke[1] published in the October–December 2018 issue of the Pediatric Respirology and Critical Care Medicine. The authors nicely determined, in a case–control study, the prevalence, pattern, and factors associated with pulmonary function abnormalities in Nigerian children with sickle cell anemia (SCA). On employing spirometry, the authors measured various components of pulmonary function tests (PFTs). They found that SCA children had lower lung volumes and capacities and higher prevalence of abnormal pulmonary function parameters compared to the controls, and a restrictive ventilatory pattern (22.1%) was the most common type.[1] I presume that such results ought to be cautiously interpreted. The authors mentioned few study limitations, namely, the absence of total lung capacity, functional residual volume, and diffusion capacity of carbon monoxide which could have further characterize the type of abnormalities of pulmonary function noticed in the studied cohort.[1] I presume that the following methodological limitation could cast additional suspicions on the study results. The authors mentioned that they referred to the reference values by Knudson et al.[2] to interpret the recorded spirometric readings. It is obvious that population-specific standard could yield a better idea of the pulmonary function status than using a foreign population reference standard. Actually, the reference values by Knudson et al.[2] is old dated back to 1983 and was constructed for Mexican-American ethnic population. It is neither valid nor worthy to be employed for Nigerian population. This is based on the observation that applying prediction formula derived for Caucasian population always overestimated the values for African ethnic population.[3] To my knowledge, spirometric standards for healthy Nigerian children and adolescents have been already constructed to be employed in the clinical settings and researches.[4] I wonder why the authors did not refer to the national standards in the methodology. I presume that if they employed that standards, different results might be obtained. Interestingly, new Nigerian spirometric values for healthy pediatric population has recently been launched.[5] Implementing that new standards in futures studies to better delineate the prevalence, type, and factors controlling pulmonary function in the SCA population is suggested. Despite the aforementioned limitations, the reported abnormal PFT in one-third of the studied SCA cohort[1] is high, necessitating routine assessment of lung function to preserve pulmonary health and improve quality of life.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Kuti BP, Adegoke SA. Pulmonary function abnormalities in Nigerian children with sickle cell anaemia: Prevalence, pattern and predictive factors. Pediatr Respirol Crit Care Med 2018;2:73-9.
2Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 1983;127:725-34.
3Njoku CH, Anah CO. Reference values for peak expiratory flow rate in adults of African descent. Trop Doct 2004;34:135-40.
4Olanrewaju DM. Spirometric standards for healthy Nigerian children and adolescents. East Afr Med J 1991;68:812-9.
5Akhiwu HO, Aliyu I. Spirometric values in healthy Nigerian school children aged 6-11 years. J Adv Med Med Res 2017;22:1-8.