Peak expiratory flow rate in healthy urban Nigerian school children in Abuja, Nigeria

Adeniyi, Folasade (2018-11)

Thesis (MMed)--Stellenbosch University, 2018.

Thesis

ENGLISH ABSTRACT: Background Recent asthma management guidelines have reiterated the importance of lung function testing, such as Peak expiratory flow rate (PEFR), in the diagnosis and management of childhood asthma. Interpretation of PEFR requires comparison with patient’s personal best value or comparison with predicted norms. PEFR has been shown to vary with age, gender, anthropometric indices and importantly with race and ethnicity even within the same country. It is therefore important to establish reference ranges for different population groups. Objectives This study aimed to establish the pattern and determinants of PEFR amongst healthy Nigerian children aged 6-12 years attending public schools in Abuja, Nigeria and to derive a prediction equation for PEFR for this population. Methods The study was a cross-sectional descriptive study design involving a representative sample of 1067 healthy children aged 6-12 years attending 7 public primary schools in Abuja, Nigeria, obtained by a multistage stratified random sampling technique. Data collection took place in the selected schools following ethics approval and written informed consent in October 2009. Demographic and clinical history data were collected on questionnaires and structured case report forms. PEFR was measured with a mini-Wright’s peak flow meter with the best of three readings recorded in litres/minute. Height and weight were measured according to recognized standards. Data was analysed with SPSS™ statistical software version 25. Confidentiality of data was ensured. Results A total of 1067 school children aged 6-12 years were included in the study; of these, 512 (48%) were males, while 555 (52%) were females. The mean PEFR in litres/minute (+2SD) were: females 214.7 (±58.7) and males 217.7(±57.2), respectively. PEFR correlated with age and anthropometric measurements, with height showing the best correlation. Gender was not significantly correlated with PEFR. Using Multiple linear regression analysis, we derived a prediction equation for use in both genders: predicted PEFR (Litres/minute) = 2.6(height in cm) + 6.9(age in years) - 185. Conclusion The prediction equation for PEFR derived from this study provides reference values for PEFR which will be useful in the recognition and management of childhood asthma and other respiratory conditions amongst Nigerian children.

AFRIKAANSE OPSOMMING: Agtergrond Onlangse riglyne vir die behandeling van asma beklemtoon die belangrikheid van longfunksie toetsing, soos byvoorbeeld Piek ekspiratoriese vloeitempo (PEFR), in die diagnose en hantering van asma in kinders. Interpretasie van PEFR vereis vergelyking met die pasiënt se eie beste waarde of voorspelde norms. PEFR varieer met ouderdom, geslag, antropometriese indekse en, belangriker, met ras en etnisiteit, selfs binne dieselfde land. Dit is dus belangrik om verwysingswaardes vir verskillende bevolkingsgroepe te vestig. Doel Hierdie studie het ten doel gehad om om die patroon en determinante van PEFR onder gesonde Nigeriese kinders tussen die ouderdomme van 6-12 jaar wat openbare skole in Abuja, Nigerië, bywoon, vas te stel, en om ‘n voorspellingsvergelyking vir PEFR in hierdie bevolking te herlei. Metode Die studie was ‘n deursnee beskrywende studie ontwerp. ‘n Verteenwoordigende monster van 1067 gesonde kinders tussen 6-12 jaar in 7 openbare laerskole in Abuja, Nigerië, is deur ‘n multi-fase gestratifiseerde ewekansige steekproefnemingstegniek verkry. Data versameling het in die verkose skole plaasgevind nadat etiek goedkeuring en geskrewe ingeligte toestemming in Oktober 2009 verkry is. Demografiese en kliniese geskiedenis data is deur middel van vraeboë en gestruktureerde gevalverslagvorms ingesamel. PEFR is deur middel van ‘n mini-Wright piekvloeimeter gemeet, met die beste van drie lesings in liters/minuut aangeteken. Lengte en massa is volgens erkende standaarde gemeet. Data is deur middel van SPSS™ statistiese sagteware weergawe 25 geanaliseer. Konfidensialiteit van die data is verseker. Resultate ‘n Totaal van 1067 skoolkinders tussen die ouderdomme van 6-12 jaar is in die studie ingesluit; 512 (48%) was manlik en 555 (52%) vroulik. Die gemiddelde PEFR in liter/minuut (+2SD) was: vroulik 214.7 (58.7) en manlik 217.7 (57.2), onderskeidelik. PEFR het met ouderdom en antropometriese metings gekorreleer, met lengte wat die beste korrelasie getoon het. Geslag het nie aansienlik met PEFR gekorreleer nie. Deur middel van lineêre regressie-analise het ons ‘n voorspellingsvergelyking vir gebruik in beide geslagte herlei: Voorspelde PEFR (Liter/minuut) = 2.6(lengte in sm) + 6.9(ouderdom in jare) - 185. Samevatting Die voorspellingsvergelyking vir PEFR wat deur middel van hierdie studie herlei is, verskaf verwysingswaardes vir PEFR wat waardevol sal wees in die herkenning en hantering van asma en ander respiratoriese toestande in Nigeriese kinders.

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