An evaluation of spirometric reference equations for detecting obstructive airway disease in South African children: A cohort study

<b>What the study adds.</b> This study reveals significant variability in rates of paediatric obstructive lung disease across ethnic groups in South Africa, emphasising discrepancies between the Global Lung Initiative 2012 and Polgar reference equations. It underscores the limitations of non-region-specific lung function standards, which may result in misclassification and inconsistent diagnoses in diverse populations.<b>Implications of the findings.</b> Developing African-specific reference standards is crucial for accurate diagnosis and effective clinical interventions. Future longitudinal studies should track lung function growth across ethnic and socioeconomic groups, offering deeper insights and enhancing diagnostic precision. Expanding research to include more diverse ethnic representation will strengthen the applicability of findings and support equitable healthcare for paediatric respiratory conditions across the continent.