{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:01:17Z","timestamp":1790420477613,"version":"4.1.0"},"posted":{"date-parts":[[2026,9,23]]},"group-title":"Epidemiology","reference-count":67,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Population-based spirometry data from sub-Saharan Africa remain limited. We characterised lung function, chronic obstructive pulmonary disease (COPD), lung restriction and associated factors from two Sub-Saharan African countries.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    We performed spirometry using ndd Easy On-PC spirometers among adults aged \u226540 years from population-based cohorts in four communities in Burkina Faso and South Africa from January 2019\u2013April 2022. We included 1,619 participants (936 women, 683 men) with repeatable forced expiratory volume in one second (FEV\n                    <jats:sub>1<\/jats:sub>\n                    ) and forced vital capacity (FVC). COPD was defined as FEV\n                    <jats:sub>1<\/jats:sub>\n                    \/FVC&lt;0.70 and lung restriction as FEV\n                    <jats:sub>1<\/jats:sub>\n                    \/FVC\u22650.70, with FVC&lt;80% predicted. We used multivariable models to test factors associated with lung function measurements (FEV\n                    <jats:sub>1<\/jats:sub>\n                    , FVC and FEV\n                    <jats:sub>1<\/jats:sub>\n                    \/FVC), COPD and lung restriction.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Median FEV\n                    <jats:sub>1<\/jats:sub>\n                    and FVC ranged from 1.940\u20132.273L and 2.521\u20132.883L, respectively. COPD prevalence was 16.1% (95% CI 14.4\u201318.0; site range 10.8%\u201324.5%) and lung restriction prevalence was 21.3% (95% CI 19.4\u201323.4; site range 11.3%\u201336.2%). Prior tuberculosis was associated with higher odds of COPD (OR 2.86, 95% CI 1.75\u20134.59) and lower FEV\n                    <jats:sub>1<\/jats:sub>\n                    , FVC and FEV\n                    <jats:sub>1<\/jats:sub>\n                    \/FVC. HIV infection was associated with higher COPD odds (OR 1.67, 95% CI 1.01\u20132.72) and lower FEV\n                    <jats:sub>1<\/jats:sub>\n                    \/FVC. Hypertension was associated with higher lung restriction odds (OR 1.46, 95% CI 1.07\u20132.00) and lower FEV\n                    <jats:sub>1<\/jats:sub>\n                    and FVC. Diabetes was associated with lower COPD odds (OR 0.50, 95% CI 0.24\u20130.94), lower FVC and higher FEV\n                    <jats:sub>1<\/jats:sub>\n                    \/FVC. Ever-smoking and older age were associated with higher COPD odds (OR 2.21, 95% CI 1.48\u20133.32; OR 1.05, 95% CI 1.03\u20131.07, respectively); older age was associated with higher lung restriction odds (OR 1.02, 95% CI 1.00\u20131.04).\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This multisite study highlights substantial heterogeneity in COPD and lung restriction prevalence across African populations and identifies respiratory multimorbidity with infectious and cardiometabolic conditions. These findings provide population-based evidence to inform respiratory surveillance in sub-Saharan Africa.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.22.26363668","type":"posted-content","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:40:24Z","timestamp":1790210424000},"source":"Crossref","is-referenced-by-count":0,"title":["Lung function variability and the burden of COPD and lung restriction in South Africa and Burkina Faso: results from the AWI-Gen study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1625-012X","authenticated-orcid":false,"given":"Emmanuel","family":"Adonyo","sequence":"first","affiliation":[{"name":"Division of Public Health and Epidemiology, School of Medical Sciences, University of Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Public Health and Epidemiology, School of Medical Sciences, University of Leicester, UK"},{"name":"University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"John","sequence":"additional","affiliation":[{"name":"Division of Public Health and Epidemiology, School of Medical Sciences, University of Leicester, UK"},{"name":"University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2459-1020","authenticated-orcid":false,"given":"Richard","family":"Packer","sequence":"additional","affiliation":[{"name":"Division of Public Health and Epidemiology, School of Medical Sciences, University of Leicester, UK"},{"name":"University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Ramsay","sequence":"additional","affiliation":[{"name":"Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Batini","sequence":"additional","affiliation":[{"name":"Division of Public Health and Epidemiology, School of Medical Sciences, University of Leicester, UK"},{"name":"University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"van Zyl-Smit","sequence":"additional","affiliation":[{"name":"The Division of Pulmonology and University of Cape Town Lung Institute, Department of Medicine, University of Cape Town, and Groote Schuur Hospital, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervyn","family":"Mer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Divisions of Critical Care and Pulmonology, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palwende Romuald","family":"Boua","sequence":"additional","affiliation":[{"name":"Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, South Africa"},{"name":"Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sant\u00e9, Nanoro, Burkina Faso"},{"name":"Medical Research Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godfred","family":"Agongo","sequence":"additional","affiliation":[{"name":"Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana"},{"name":"Department of Epidemiology, School of Public Health, C K Tedam University of Technology and Applied Sciences, Navrongo, Ghana and Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C K Tedam University of Technology and Applied Sciences, Navrongo, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F Xavier","family":"G\u00f3mez-Oliv\u00e9","sequence":"additional","affiliation":[{"name":"SAMRC\/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reneilwe Given","family":"Mashaba","sequence":"additional","affiliation":[{"name":"Dikgale Mamabolo Mothiba (DIMAMO) Population Health Research Centre, University of Limpopo, Polokwane, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin D.","family":"Tobin","sequence":"additional","affiliation":[{"name":"Division of Public Health and Epidemiology, School of Medical Sciences, University of Leicester, UK"},{"name":"University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1860-6337","authenticated-orcid":false,"given":"Anna L.","family":"Guyatt","sequence":"additional","affiliation":[{"name":"Division of Public Health and Epidemiology, School of Medical Sciences, University of Leicester, UK"},{"name":"University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa K.","family":"Micklesfield","sequence":"additional","affiliation":[{"name":"SAMRC\/Wits Ageing African Adult Research Unit, Faculty of Health Sciences, University of the Witwatersrand, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026092603250768000_2026.09.22.26363668v1.1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00239-2023"},{"key":"2026092603250768000_2026.09.22.26363668v1.2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200703-456SO"},{"key":"2026092603250768000_2026.09.22.26363668v1.3","unstructured":"Chronic obstructive pulmonary disease (COPD) [Internet]. [cited 2026 Sep 9]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/chronic-obstructive-pulmonary-disease-(copd)"},{"key":"2026092603250768000_2026.09.22.26363668v1.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmjph-2024-002489"},{"key":"2026092603250768000_2026.09.22.26363668v1.5","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.21.0394"},{"key":"2026092603250768000_2026.09.22.26363668v1.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102215"},{"key":"2026092603250768000_2026.09.22.26363668v1.7","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16010062"},{"key":"2026092603250768000_2026.09.22.26363668v1.8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.46598"},{"key":"2026092603250768000_2026.09.22.26363668v1.9","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-019-0946-z"},{"key":"2026092603250768000_2026.09.22.26363668v1.10","doi-asserted-by":"publisher","DOI":"10.4104\/pcrj.2011.00027"},{"key":"2026092603250768000_2026.09.22.26363668v1.11","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-2535"},{"key":"2026092603250768000_2026.09.22.26363668v1.12","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70337-7"},{"key":"2026092603250768000_2026.09.22.26363668v1.13","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.19.0015"},{"key":"2026092603250768000_2026.09.22.26363668v1.14","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2014.908834"},{"key":"2026092603250768000_2026.09.22.26363668v1.15","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.12.0619"},{"key":"2026092603250768000_2026.09.22.26363668v1.16","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200506-975OC"},{"key":"2026092603250768000_2026.09.22.26363668v1.17","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.0021711"},{"key":"2026092603250768000_2026.09.22.26363668v1.18","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-68372-w"},{"key":"2026092603250768000_2026.09.22.26363668v1.19","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"2026092603250768000_2026.09.22.26363668v1.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61377-4"},{"issue":"2","key":"2026092603250768000_2026.09.22.26363668v1.21","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1081\/COPD-57610","article-title":"The Burden of Obstructive Lung Disease Initiative (BOLD): rationale and design","volume":"2","year":"2005","journal-title":"COPD"},{"key":"2026092603250768000_2026.09.22.26363668v1.22","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201701-0205OC"},{"key":"2026092603250768000_2026.09.22.26363668v1.23","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyad146"},{"key":"2026092603250768000_2026.09.22.26363668v1.24","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202005-1990OC"},{"key":"2026092603250768000_2026.09.22.26363668v1.25","doi-asserted-by":"publisher","DOI":"10.2174\/1874306401610010086"},{"key":"2026092603250768000_2026.09.22.26363668v1.26","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-022-01939-5"},{"key":"2026092603250768000_2026.09.22.26363668v1.27","doi-asserted-by":"publisher","DOI":"10.1017\/gheg.2016.17"},{"key":"2026092603250768000_2026.09.22.26363668v1.28","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyae173"},{"key":"2026092603250768000_2026.09.22.26363668v1.29","doi-asserted-by":"publisher","DOI":"10.5195\/jmla.2018.319"},{"key":"2026092603250768000_2026.09.22.26363668v1.30","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0321-7"},{"key":"2026092603250768000_2026.09.22.26363668v1.31","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.1.9712108"},{"key":"2026092603250768000_2026.09.22.26363668v1.32","doi-asserted-by":"publisher","DOI":"10.25259\/JPATS_13_2026"},{"key":"2026092603250768000_2026.09.22.26363668v1.33","doi-asserted-by":"publisher","DOI":"10.1097\/01.NPR.0000000000000180"},{"key":"2026092603250768000_2026.09.22.26363668v1.34","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-007-9052-8"},{"key":"2026092603250768000_2026.09.22.26363668v1.35","doi-asserted-by":"publisher","DOI":"10.1186\/s40248-017-0084-5"},{"key":"2026092603250768000_2026.09.22.26363668v1.36","doi-asserted-by":"publisher","DOI":"10.1101\/2024.08.22.24312411"},{"key":"2026092603250768000_2026.09.22.26363668v1.37","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2018.1507133"},{"key":"2026092603250768000_2026.09.22.26363668v1.38","unstructured":"ndd-Medical-Easy-On-PC-Spirometry-Operators-Manual.pdf [Internet]. [cited 2023 May 23]. Available from: https:\/\/henrotech.be\/sites\/default\/files\/product\/manual\/ndd-Medical-Easy-On-PC-Spirometry-Operators-Manual.pdf"},{"key":"2026092603250768000_2026.09.22.26363668v1.39","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.21.0724"},{"key":"2026092603250768000_2026.09.22.26363668v1.40","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.098483"},{"key":"2026092603250768000_2026.09.22.26363668v1.41","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00023202"},{"key":"2026092603250768000_2026.09.22.26363668v1.42","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01603-2024"},{"key":"2026092603250768000_2026.09.22.26363668v1.43","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61303-9"},{"key":"2026092603250768000_2026.09.22.26363668v1.44","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-1253"},{"key":"2026092603250768000_2026.09.22.26363668v1.45","doi-asserted-by":"publisher","DOI":"10.1038\/npjpcrm.2016.50"},{"key":"2026092603250768000_2026.09.22.26363668v1.46","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201608-598OC"},{"key":"2026092603250768000_2026.09.22.26363668v1.47","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1464"},{"key":"2026092603250768000_2026.09.22.26363668v1.48","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-011-9296-1"},{"key":"2026092603250768000_2026.09.22.26363668v1.49","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-1435"},{"key":"2026092603250768000_2026.09.22.26363668v1.50","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2010.03073.x"},{"key":"2026092603250768000_2026.09.22.26363668v1.51","doi-asserted-by":"publisher","DOI":"10.1900\/RDS.2012.9.23"},{"key":"2026092603250768000_2026.09.22.26363668v1.52","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-2622"},{"key":"2026092603250768000_2026.09.22.26363668v1.53","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v11.i10.425"},{"key":"2026092603250768000_2026.09.22.26363668v1.54","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201803-184OC"},{"key":"2026092603250768000_2026.09.22.26363668v1.55","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/5492680"},{"key":"2026092603250768000_2026.09.22.26363668v1.56","doi-asserted-by":"publisher","DOI":"10.1080\/15412555.2020.1769583"},{"key":"2026092603250768000_2026.09.22.26363668v1.57","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0273063"},{"key":"2026092603250768000_2026.09.22.26363668v1.58","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0256121"},{"key":"2026092603250768000_2026.09.22.26363668v1.59","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0077-2017"},{"key":"2026092603250768000_2026.09.22.26363668v1.60","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(25)00105-6"},{"key":"2026092603250768000_2026.09.22.26363668v1.61","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02325-2014"},{"key":"2026092603250768000_2026.09.22.26363668v1.62","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(25)00548-1"},{"key":"2026092603250768000_2026.09.22.26363668v1.63","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.05.011"},{"key":"2026092603250768000_2026.09.22.26363668v1.64","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-022-02062-3"},{"issue":"6","key":"2026092603250768000_2026.09.22.26363668v1.65","first-page":"613","article-title":"Risk factors for prevalence of and mortality related to restriction on spirometry: findings from the First National Health and Nutrition Examination Survey and follow-up","volume":"9","year":"2005","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026092603250768000_2026.09.22.26363668v1.66","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-physiol-021119-034610"},{"key":"2026092603250768000_2026.09.22.26363668v1.67","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202302-0310ST"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.09.22.26363668","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:25:16Z","timestamp":1790418316000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2026.09.22.26363668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":67,"URL":"https:\/\/doi.org\/10.64898\/2026.09.22.26363668","relation":{},"subject":[],"published":{"date-parts":[[2026,9,23]]},"subtype":"preprint"}}