title: Spirometric reference values in urban children in Madagascar: poverty is a risk factor for low lung function.
abstract: BACKGROUND
  Studies about children with respiratory diseases in Africa are impeded by the dearth of reliable data for the vast majority of countries on the continent. This study was conducted to establish representative reference values, therefore allowing a more accurate evaluation of lung function in Malagasy children.
  
  
  METHODS
  One thousand two hundred thirty-six students from three public and five private schools aged 8-12 years were recruited. A total of 1,093 children were healthy, had a valid lung function measurement and were thus deemed evaluable for this study. Lung function data were collected on consecutive days in Antananarivo, Madagascar's capital, using spirometry and a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.
  
  
  RESULTS
  The lung volumes found were substantially lower compared to Caucasian and African equations. The mean Z-score (Stanojevic) for the forced vital capacity (FVC) found was -1.45 and -0.93 for the forced expiratory volume in 1 sec (FEV1) with significant differences between private and public schools (FVC: P = 0.0023, FEV1: P = 0.0004).
  
  
  CONCLUSIONS
  The equations established for school children in Madagascar's capital Antananarivo showed lung function values were lower than reference values for the same age group seen not only in European, but also in African American and African children. The unique ethnicity of the Malagasy people, which combines Southeast-Asian with substantial African influences, the heavy burden of pollution and poverty may explain these differences.
authors: Pediatric Practice, Pfullendorf, Germany.
authors: Peter Th
authors: PT
authors: Wolff
authors: Lala
authors: L
authors: Arison
authors: Abel
authors: A
authors: Rahajamiakatra
authors: Francis
authors: F
authors: Raserijaona
authors: Bodo
authors: B
authors: Niggemann
mesh_terms: D000886:Anthropometry; D001249:Asthma / Q000175:diagnosis; D002648:Child; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis; D008168:Lung / Q000502:physiology*; D008176:Lung Volume Measurements; D008270:Madagascar; D008297:Male; D011203:Poverty; D012016:Reference Values; D012129:Respiratory Function Tests; D013147:Spirometry; D011795:Surveys and Questionnaires; D014505:Urban Population; D014797:Vital Capacity
keywords: Africa; Madagascar; Polynesia; children; lung function; poverty; reference values; spirometry