{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T19:16:15Z","timestamp":1788290175455,"version":"build-2803163510"},"reference-count":43,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2026,1,20]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The high prevalence of COPD in sub-Saharan Africa is poorly understood. In high-income countries, COPD is the consequence of suboptimal lung growth during childhood and\/or accelerated lung function decline in adult life. We have conducted cross-sectional studies to measure the lung function of children and adults in Kenya and to identify associations with age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed spirometry in three groups in Kenya: a random sample of schoolchildren in two districts of urban Nairobi and age\/sex-stratified representative community samples of adults in Nairobi and rural Machakos. Forced expiratory volume in 1\u2005s (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ) and forced vital capacity were expressed as z-scores using race-neutral GLI-Global reference equations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean (95% CI) FEV\n                      <jats:sub>1<\/jats:sub>\n                      z-score in Nairobi schoolchildren (n=2373, median age 10\u2005years (IQR 8\u201313) 52% girls) was \u22120.60 (\u22120.64\u2013\u2005\u22120.55); in Nairobi adults (n=2936, median age 32\u2005years (24\u201343), 62% female) \u22120.49 (\u22120.53\u2013\u2005\u22120.45); and in Machakos adults (n=1607, median age 46\u2005years (35\u201359), 65% female) \u22120.67 (\u22120.72\u2013\u2005\u22120.61). In adults, FEV\n                      <jats:sub>1<\/jats:sub>\n                      was negatively associated with age (FEV\n                      <jats:sub>1<\/jats:sub>\n                      z-score regression coefficient \u03b2 \u22120.005\/year (95% CI \u22120.009\u2013\u2005\u22120.002) p=0.005, and there was a negative interaction between residence in Nairobi and age, \u03b2 \u22120.006\/year (95% CI \u22120.011\u2013\u2005\u22120.001), p=0.020.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The lung function of children and adults in Kenya was lower than predicted by race-neutral Global Lung Function Initiative (GLI)-Global reference equations. In adults, a negative association between lung function and age was greater in urban, than in rural, settings. Further work is required to identify and mitigate relevant influences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/23120541.01577-2025","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T18:15:26Z","timestamp":1774548926000},"page":"01577-2025","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lung function across the life course in Kenya: a series of cross-sectional surveys"],"prefix":"10.1183","volume":"12","author":[{"given":"Hellen","family":"Meme","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Matu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Orina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Miheso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kiplimo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos","family":"Ndombi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Immaculate","family":"Kathure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kinyanjui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evans","family":"Amukoye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah","family":"Chakaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nengjie","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cressida","family":"Bowyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy M.","family":"Gray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maia","family":"Lesosky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Mortimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Semple","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"West","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Zurba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9722-6265","authenticated-orcid":false,"given":"Amsalu B.","family":"Binegdie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6989-8862","authenticated-orcid":false,"given":"Asma","family":"El Sony","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Devereux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"2026090111401279000_12.4.01577-2025.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"2026090111401279000_12.4.01577-2025.2","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/S2213-2600(17)30293-X","article-title":"Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"5","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2026090111401279000_12.4.01577-2025.3","unstructured":"World Health Organisation . 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