article · Frontiers in Pediatrics
A study in northern and eastern Uganda investigated lung function abnormalities in 362 children and adolescents aged 6-18 with homozygous sickle cell disease. Researchers used spirometry and found that 41.7% of participants had abnormal results. The most common pattern was restrictive (67.5%), followed by obstructive (27.8%). Key factors linked to these abnormalities included increasing age, with adolescents having a thirteen-fold higher risk than younger children. Being underweight, not completing recommended pneumococcal vaccinations, and a history of recurrent acute chest syndrome were also significantly associated with abnormal spirometry. The findings suggest a high prevalence of lung issues in this population and support routine spirometry testing in paediatric sickle cell disease care.
This research highlights the significant burden of lung function problems in Ugandan children and adolescents with sickle cell disease. Recognising these early markers and associated risk factors can help clinicians intervene sooner, potentially improving long-term respiratory health and quality of life for affected individuals.
The findings support the integration of routine spirometry testing into paediatric sickle cell disease care. This indicates a need for improved clinical protocols and potentially increased demand for spirometry equipment and training in healthcare facilities in Uganda. The research is applied and suggests a clear pathway for enhancing existing diagnostic and surveillance practices.
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Background Abnormal spirometry indices are known to be early markers of long-term respiratory dysfunction in the sickle cell disease (SCD) population. In Sub-Saharan Africa, however, evidence remains scarce. This study aimed to assess the prevalence, patterns, and factors associated with spirometry abnormalities among children and adolescents with homozygous SCD in Uganda. Methods A cross-sectional study was conducted between september and december 2025 at Jinja and Lira Regional Referral Hospitals. Clinically stable children aged 6–18 years with confirmed homozygous SCD were consecutively enrolled. Sociodemographic and clinical data were collected using structured questionnaires, and spirometry was performed and results were interpreted using the Global Lung Initiative 2012 reference equations (GLI-12). Logistic-regression models identified factors independently associated with spirometry abnormalities. Results Among 362 participants (mean age 11.7 ± 3.2 years; 53.1% male), 41.7% had abnormal spirometry. The restrictive spirometry pattern predominated (67.5%), followed by obstructive (27.8%) and mixed (4.6%) patterns. The odds of abnormal spirometry increased threefold among children 8–12 years (aOR = 3.346; 95% CI 1.375–8.142; p = 0.008) and rose over thirteen-fold in adolescents 13–18 years (aOR = 13.532; 95% CI 5.687–32.201; p < 0.001). Being underweight was associated with a four-fold higher risk (aOR = 3.871; 95% CI 2.189–6.845; p < 0.001). Children who had not completed all recommended pneumococcal-conjugate-vaccine (PCV) doses had a 3.5-fold greater risk (aOR = 3.474; 95% CI 1.618–9.153; p = 0.022). A history of recurrent acute chest syndrome was also associated with spirometry abnormalities (aOR = 3.295; 95% CI 1.016–14.526; p = 0.044). Conclusion Spirometry abnormalities were highly prevalent among children and adolescents with SCD in Northern and Eastern Uganda, with a predominance of restrictive spirometric patterns. Increasing age, undernutrition, incomplete pneumococcal vaccination, and previous ACS episodes were independently associated with abnormal spirometry. These findings support the integration of routine spirometry testing and surveillance into pediatric SCD care in the clinical setting.
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DOI: 10.3389/fped.2026.1891576
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