Changing lung function and associated health-related quality-of-life: A five-year cohort study of Malawian adults.
Changing lung function and associated health-related quality-of-life: A five-year cohort study of Malawian adults.
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DOI：
10.1016/j.eclinm.2021.101166
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发表时间：
2021-11
影响因子：
15.1
通讯作者：
IMPALA consortium
中科院分区：
文献类型：
--
作者：
Njoroge MW;Mjojo P;Chirwa C;Rylance S;Nightingale R;Gordon SB;Mortimer K;Burney P;Balmes J;Rylance J;Obasi A;Niessen LW;Devereux G;IMPALA consortium
在撒哈拉以南非洲地区的横断面研究报告显示，表明慢性呼吸道疾病的肺功能异常患病率很高。低收入和中等收入国家这种肺功能异常的自然史和健康影响在很大程度上尚不清楚。 2014 年招募了代表马拉维 Chikwawa 农村地区 1481 名成年人的队列，并于 2019 年进行了随访。对呼吸道症状和健康相关生活质量 (HRQoL) 进行了量化。通过肺活量测定法测量肺功能。 1232 名（83%）成年人参与； 1082 人（73%）可以进行肺活量测定。平均 (SD) 年龄 49.5 (17.0) 岁，278 人 (23%) 曾吸烟，其中 724 人 (59%) 为女性。一秒用力呼气量 (FEV1) 下降 53.4 毫升/年 (95% CI: 49.0, 57.8)，用力肺活量 (FVC) 下降 45.2 毫升/年 (95% CI: 39.2, 50.5)。慢性气流阻塞从 2014 年的 9.5%（7.6，11.6%）增加到 2019 年的 17.5%（15.3，19.9%）。诊断的哮喘或肺活量测定与哮喘或限制一致没有变化。 FEV1 下降率与诊断的慢性阻塞性肺病 (COPD)、哮喘或与哮喘、COPD 或限制一致的肺活量测定无关。 HRQoL 与呼吸道症状（呼吸困难、喘息、咳嗽）、既往结核病、FEV1 下降和肺活量测定（与哮喘或限制一致）呈负相关。这些差异超出了最小重要差异。在该队列中，COPD 患病率的增加与 FEV1 下降率高以及招募前出现的肺功能缺陷有关。呼吸系统症状和肺功能欠佳与 HRQoL 降低独立相关。
In Sub-Saharan Africa cross-sectional studies report a high prevalence of abnormal lung function indicative of chronic respiratory disease. The natural history and health impact of this abnormal lung function in low-and middle-income countries is largely unknown. A cohort of 1481 adults representative of rural Chikwawa in Malawi were recruited in 2014 and followed-up in 2019. Respiratory symptoms and health-related quality of life (HRQoL) were quantified. Lung function was measured by spirometry. 1232 (83%) adults participated; spirometry was available for 1082 (73%). Mean (SD) age 49.5 (17.0) years, 278(23%) had ever smoked, and 724 (59%) were women. Forced expiratory volume in one second (FEV1) declined by 53.4 ml/year (95% CI: 49.0, 57.8) and forced vital capacity (FVC) by 45.2 ml/year (95% CI: 39.2, 50.5) . Chronic airflow obstruction increased from 9.5% (7.6, 11.6%) in 2014 to 17.5% (15.3, 19.9%) in 2019. There was no change in diagnosed asthma or in spirometry consistent with asthma or restriction. Rate of FEV1 decline was not associated with diagnosed Chronic obstructive pulmonary disease (COPD), asthma, or spirometry consistent with asthma, COPD, or restriction. HRQoL was adversely associated with respiratory symptoms (dyspnoea, wheeze, cough), previous tuberculosis, declining FEV1 and spirometry consistent with asthma or restriction. These differences exceeded the minimally important difference. In this cohort, the increasing prevalence of COPD is associated with the high rate of FEV1 decline and lung function deficits present before recruitment. Respiratory symptoms and sub-optimal lung function are independently associated with reduced HRQoL.
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DOI：
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发表时间：
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期刊：
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影响因子：
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作者：
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DOI：
10.1164/rccm.201805-0936oc
发表时间：
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影响因子：
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