Spirometry Assessments in Children With Sickle Cell Disease in Ghana

ABSTRACT Background Pulmonary disease in children with SCD is common and heterogeneous and includes pulmonary function impairment. This study aimed to investigate spirometry patterns in Ghanaian children with SCD and factors that contribute to low lung function. Methods A case‐control study involving children aged 6–16 years with and without SCD was carried out at the Komfo Anokye Teaching Hospital. Demographic, socio‐economic, and clinical information were collected. Spirometry was performed for both cases and controls at enrolment and interpreted based on the GLI‐Black reference equation. Logistic and linear regression analyses were performed. Results A total of 115 cases and 115 controls were recruited for the study. Children with SCD had significantly lower anthropometric measurements, lower lung volumes compared to the controls: median (IQR) BMI z‐scores; cases vs controls, −0.5 (−1.3 to 0.3); versus −0.2 (−0.9 to 0.8) p = 0.01, mean z‐ scores for forced expiratory volume in 1 s (FEV 1) , cases vs controls, −1.0 (SD1.2) vs −0.4 (SD 1.2) z‐score, ( p < 0.001), mean z‐scores for forced vital capacity (FVC z‐scores), cases versus controls, −0.8 (SD1.2) z score vs −0.3 (SD 1.3) z‐score, ( p < 0.001). Abnormal lung function was significantly more common in cases than controls, 42% ( n = 48) and 17.4% ( n = 20) respectively. The lung function abnormalities noted were as follows: restrictive pattern, cases versus controls [24.3% ( n = 28) vs 12.2% ( n = 14)] ( p < 0.001), obstructive pattern [14.8% ( n = 17) versus 5.2% ( n = 6)] ( p < 0.001), mixed pattern [2.6% ( n = 3) versus 0 ( p < 0.001). Being female and having higher BMI z‐scores were associated with significantly lower odds of having a restrictive lung function pattern compared to normal lung function, OR 0.31 (95% CI 0.16, 0.58) ( p < 0.001). Conclusion This study has demonstrated a predominance of low anthropometric measurements and restrictive abnormality on spirometry in children with SCD in Ghana. Females and those with higher BMI z‐scores had significantly lower odds of having a restrictive lung function pattern compared to normal lung function.