Pulmonary Function Testing in Healthy Infants in Rural Bangladesh: Feasibility Study.

Charl Verwey, Hm Golam Kibria Sojib, Md Shafiqul Islam, Arunangshu Dutta Roy, Md Asmd Ashraful Islam, Nabidul H Chowdhury, Dorottya Czovek, Gergely Makan, Salahuddin Ahmed, Abdullah H Baqui, Zoltan Hantos, Eric D McCollum
Author Information
  1. Charl Verwey: Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa. ORCID
  2. Hm Golam Kibria Sojib: Projahmo Research Foundation, Dhaka, Bangladesh.
  3. Md Shafiqul Islam: Projahmo Research Foundation, Dhaka, Bangladesh.
  4. Arunangshu Dutta Roy: Projahmo Research Foundation, Dhaka, Bangladesh.
  5. Md Asmd Ashraful Islam: Projahmo Research Foundation, Dhaka, Bangladesh.
  6. Nabidul H Chowdhury: Projahmo Research Foundation, Dhaka, Bangladesh. ORCID
  7. Dorottya Czovek: Department of Paediatrics, Semmelweis University, Budapest, Hungary.
  8. Gergely Makan: Department of Technical Informatics, University of Szeged, Szeged, Hungary.
  9. Salahuddin Ahmed: Projahmo Research Foundation, Dhaka, Bangladesh.
  10. Abdullah H Baqui: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
  11. Zoltan Hantos: Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary.
  12. Eric D McCollum: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.

Abstract

BACKGROUND: Infant pulmonary function testing (iPFT) in low- and middle-income countries is limited. We evaluated the early feasibility of iPFT in rural Bangladesh.
METHODS: Experts established an iPFT laboratory at Zakiganj Upazila Health Complex in Sylhet, Bangladesh and trained staff. Infants ������6 months old participating in a cohort study between 2021 and 2022 were eligible for respiratory oscillometry (Osc), tidal breath flow-volume loops (TBFVL), and sulphur hexaflouride multiple breath washout (MBW) during natural sleep. Participants with a respiratory infection within 4 weeks were not tested. Among the first 25 infants with attempted Osc, TBFVL, or MBW measurements, we report the test proportions meeting international quality standards, measurement averages, and the mean measurement differences between laboratory staff and experts.
RESULTS: Among the first 25 eligible infants with attempted measurements, acceptable Osc measurements were achieved in 88% (22/25), TBFVL in 96% (24/25), and MBW in 88% (22/25). Infants tested by Osc at 2 months were a median (IQR) of 81 days old (73, 85) and tested at 6 months were a median of 194 days old (193, 202); TBFVL/MBW tested infants were a mean 83 days (79, 87). Mean (SD) Osc resistance at 7���Hz was 66.3 (25.2) and 64.0 (22.4)���hPa.s.L at 2 and 6 months. At 2 months, TBFVL mean tidal volume/body weight was 7.4 (1.4)���mL/kg and MBW mean (SD) lung clearance index was 7.2 (1.0) turnovers. iPFT staff and expert interpretation differences were minimal.
CONCLUSIONS: Establishing an iPFT laboratory and performing quality measurements and expert-level interpretations in rural Bangladesh is feasible.

References

  1. Annu Rev Public Health. 2014;35:185-206 [PMID: 24641558]
  2. Lancet Respir Med. 2019 Apr;7(4):358-364 [PMID: 30765254]
  3. Nicotine Tob Res. 2019 Mar 30;21(4):416-423 [PMID: 29228385]
  4. Eur Respir J. 2000 Oct;16(4):731-40 [PMID: 11106221]
  5. Lancet Child Adolesc Health. 2022 Feb;6(2):106-115 [PMID: 34800370]
  6. Respirology. 2015 Oct;20(7):1108-14 [PMID: 26134556]
  7. Pediatrics. 1982 Sep;70(3):447-50 [PMID: 6810300]
  8. ERJ Open Res. 2023 Jun 26;9(3): [PMID: 37377657]
  9. BMJ Open Respir Res. 2023 May;10(1): [PMID: 37169402]
  10. Environ Res. 2022 Oct;213:113645 [PMID: 35700764]
  11. Eur Respir J. 2013 Mar;41(3):507-22 [PMID: 23397305]
  12. Pediatr Pulmonol. 2015 Jan;50(1):49-54 [PMID: 24339198]
  13. Am J Respir Crit Care Med. 2017 Jan 15;195(2):212-220 [PMID: 27509359]
  14. Indian Pediatr. 2020 Jan 15;57(1):25-33 [PMID: 31937694]
  15. J Glob Health. 2021 Sep 11;11:04052 [PMID: 34552721]
  16. J Appl Physiol (1985). 2019 May 1;126(5):1409-1418 [PMID: 30763165]
  17. Lancet Respir Med. 2014 Oct;2(10):823-60 [PMID: 25193349]
  18. Environ Sci Pollut Res Int. 2019 Feb;26(4):3208-3225 [PMID: 30569352]
  19. J Allergy Clin Immunol. 2021 Jul;148(1):1-14 [PMID: 34238501]
  20. Am J Respir Crit Care Med. 2010 Dec 1;182(11):1387-97 [PMID: 20622043]
  21. BMJ Open Respir Res. 2020 Feb;7(1): [PMID: 32079606]
  22. Indoor Air. 2013 Oct;23(5):379-86 [PMID: 23906055]
  23. Respirology. 2015 Apr;20(3):467-73 [PMID: 25581268]
  24. Lancet. 2017 Dec 17;388(10063):3027-3035 [PMID: 27839855]
  25. Eur Respir J. 2000 Dec;16(6):1180-92 [PMID: 11292125]
  26. Lancet Glob Health. 2020 Oct;8(10):e1316-e1325 [PMID: 32971054]
  27. Am J Respir Crit Care Med. 2007 Jun 15;175(12):1304-45 [PMID: 17545458]
  28. Rev Paul Pediatr. 2016 Dec;34(4):408-411 [PMID: 27449074]
  29. Lancet Planet Health. 2017 Nov;1(8):e328-e336 [PMID: 29167839]

Grants

  1. /This work was funded by the United States National Institute of Environmental Health Sciences (R21ES029330 to E.D.M.) and Hungarian Scientific Research Fund (K105403, FK 129237 and K128701 to D.C. and Z.H.).

MeSH Term

Humans
Bangladesh
Feasibility Studies
Infant
Respiratory Function Tests
Male
Rural Population
Female
Infant, Newborn
Cohort Studies

Word Cloud

Created with Highcharts 10.0.0iPFTmonthsOsc2TBFVLMBW4testedmeasurementsmeanBangladeshlaboratorystaffInfantsold25infantsdaysruraleligiblerespiratorytidalbreathAmongfirstattemptedqualitymeasurementdifferences88%22/25median6SD071BACKGROUND:Infantpulmonaryfunctiontestinglow-middle-incomecountrieslimitedevaluatedearlyfeasibilityMETHODS:ExpertsestablishedZakiganjUpazilaHealthComplexSylhettrained������6participatingcohortstudy20212022oscillometryflow-volumeloopssulphurhexaflouridemultiplewashoutnaturalsleepParticipantsinfectionwithinweeksreporttestproportionsmeetinginternationalstandardsaveragesexpertsRESULTS:acceptableachieved96%24/25IQR817385194193202TBFVL/MBW837987Meanresistance7���Hz6636422���hPasLvolume/bodyweight���mL/kglungclearanceindexturnoversexpertinterpretationminimalCONCLUSIONS:Establishingperformingexpert-levelinterpretationsfeasiblePulmonaryFunctionTestingHealthyRuralBangladesh:FeasibilityStudy

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