ArticleThe Lancet. Global health2024
Assessing the prevalence and impact of preserved ratio impaired spirometry in low-income and middle-income countries: a post-hoc cross-sectional analysis.
Article in The Lancet. Global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Prevalence of chronic respiratory disease using case-finding tools in adults living with noncommunicable disease in low- and middle-income countries: a systematic review.BMC pulmonary medicine · 2025Pooled it
- Prevalence of abnormal spirometry and correlates of lung function decline among a population in rural Uganda.Journal of global health · 2026Article
- Prevalence of PRISm and COPD and associated factors in a university medical centre spirometry unit: a cross-sectional analysis.BMJ open · 2026Article
- Variance-Guided Regression for Heteroscedastic Data With a Grouping-Based Extension for Nonlinear Prediction.Statistics in medicine · 2026Article
- Preserved Ratio Impaired Spirometry in the Ugandan Link Cohort: A Longitudinal Follow-Up.CHEST pulmonary · 2026Article
- Preserved Ratio Impaired Spirometry in Low- and Middle-Income Countries: An Emerging Cardiopulmonary Phenotype and Cardiovascular Risk-A Narrative Review.Life (Basel, Switzerland) · 2026Review
- Mitigating chronic respiratory disease through the lens of multimorbidity: the MARES mixed-methods study protocol.BMJ open · 2026Article
- The Inflammation-Metabolism Axis in Preserved Ratio Impaired Spirometry: Pathogenic Mechanisms and Translational Implications.Journal of inflammation research · 2026Review
- Frailty as a Key Determinant of Cardiovascular Risk and Mortality in Preserved Ratio Impaired Spirometry: A Nationally Representative Study.The clinical respiratory journal · 2026Article
- Associations of preserved ratio impaired spirometry with cardiometabolic comorbidities: a systematic review and meta-analysis.ERJ open research · 2025Article
- COPD-MMDDxNet: a multimodal deep learning framework for accurate COPD diagnosis using electronic medical records.Frontiers in medicine · 2025Article
- Associations between ultra-processed foods intake and preserved ratio impaired spirometry in U.S. adults.Frontiers in nutrition · 2025Article
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Authors and funding
24 authors.
Funding
Abstract
backgroundMore than 90% of the morbidity and mortality from chronic respiratory disease occurs in low-income and middle-income countries (LMICs), with substantial economic impact. Preserved ratio impaired spirometry (PRISm) is a prevalent lung function abnormality associated with increased mortality in high-income countries. We aimed to conduct a post-hoc analysis of a cross-sectional study to assess the prevalence of, the risk factors for, and the impact of PRISm in three diverse LMIC settings.
methodsWe recruited a random, age-stratified and sex-stratified sample of the population in semi-urban Bhaktapur, Nepal; urban Lima, Peru; and rural Nakaseke, Uganda. Quality-assured post-bronchodilator spirometry was performed to American Thoracic Society standards and PRISm was defined as a forced expiratory volume in one second (FEV
findings10 664 participants were included in the analysis, with a mean (SD) age of 56·3 (11·7) years and an equal distribution by sex. The prevalence of PRISm was 2·5% in Peru, 9·1% in Nepal, and 16·0% in Uganda. In multivariable analysis, younger age (OR for each decile of age 0·87, 95% CI 0·82-0·92) and being female (1·37, 1·18-1·58) were associated with increased odds of having PRISm. Biomass exposure was not consistently associated with PRISm across sites. Individuals with PRISm had impairment in respiratory-related quality of life as measured by the St George's Respiratory Questionnaire (OR by decile 1·18, 95% CI 1·10-1·25).
interpretationThe prevalence of PRISm is heterogeneous across LMIC settings and associated with age, female sex, and biomass exposure, a common exposure in LMICs. A diagnosis of PRISm was associated with worse health status when compared with those with normal lung function. Health systems in LMICs should focus on all spirometric abnormalities as opposed to obstruction alone, given the disease burden, reduced quality of life, and size of the undiagnosed population at risk.
fundingMedical Research Council.
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