Lung Health in the Solomon Islands: A Mixed Methods Study

Figures & data

Table 1 Baseline Patient Characteristics

		Total	Age < 40	Age ≥ 40
Number		104 total (11 inpatients, 93 outpatients)	30 (2 inpatients, 28 outpatients)	74 (9 inpatients, 65 outpatients)
Average Age		46.9 (± 13.8)	30.2 (±7.1)	53.7 (±9.4)
Sex		60 female, 44 male	13 female, 17 male	47 female, 27 male
Average BMI		29.4 (± 5.4)	27.2 (±4.7)	30.3 (±5.5)
Reported Respiratory History		5 Asthma	1 asthma	4 asthma
		11 Pneumonia	5 pneumonia	6 pneumonia
Respiratory Medications		4 salbutamol	None	4 salbutamol
		2 Beclomethasone		2 Beclomethasone
Hospital since 2018		60/96 (62.5%)	14/26 (53.9%)	46/70 (65.7%)
Chews Betelnut		56/95 (59.0%)	21/26 (80.8%)	35/69 (50.7%)
Smoking status	Never	65/104 (62.5%)	13/30 (43.3%)	52/74 (70.3%)
	Ex-smoker	14/104 (13.5%)	4/30 (13.3%)	10/74 (13.5%)
	Current	25/104 (24.0%)	13/30 (43.3%)	12/74 (16.2%)
Pack years	<10	12/39 (30.8%)	7/17 (41.2%)	5/22 (22.7%)
	10–20	14/39 (35.9%)	7/17 (41.2%)	7/22 (31.8%)
	>20	13/39 (33.3%)	3/17 (17.7%)	10/22 (45.5%)
Indoor wood fire exposure	None	27/103 (26.2%)	12/29 (41.4%)	15/74 (20.3%)
	Occasional (<10hrs/week)	23/103 (22.3%)	6/29 (20.7%)	17/74 (23.0%)
	Regular (>10hrs/week)	53/103 (51.5%)	11/29 (37.9%)	42/74 (56.8%)

Notes: Inpatients: participants admitted to hospital. Outpatients: participants not admitted to hospital.

Table 2 Spirometry Results

	Total	Age < 40	Age ≥ 40	p-value
Acceptable baseline Spirometry performed	93 (11 inpatient, 82 outpatient)	26 (2 inpatient, 24 outpatient)	67 (9 inpatient, 58 outpatient)
Best FEV1 (%)	81.3 (±17.0)	86.0 (±14.6)	79.5 (±17.7)	0.10
Best FEV1 (L)	2.29 (±0.72)	2.82 (±0.64)	2.08 (± 0.64)
Best FVC (%)	83.6 (±15.2)	89.1 (±13.0)	81.5 (±15.5)	0.03
Best FVC (L)	2.87 (±0.82)	3.45 (±0.72)	2.64 (±0.74)
FEV1/FVC	79.5 (±8.6)	81.9 (±7.6)	78.5 (±8.9)	0.10
COPD^a	3/93 (3.2%)	1/26 (2.8%)	2/67 (3.0%)	0.83
Bronchodilator responsiveness^b	9/93 (9.7%)	4/26 (15.4%)	5/67 (7.5%)	0.25
Possible restriction^c	24/93 (25.8%)	3/26 (11.5%)	21/67 (31.3%)	0.05
Preserved Ratio Impaired Spirometry (PRISm)^d	12/93 (12.9%)	3/26 (11.5%)	9/67 (13.4%)	0.81

Notes: ^aCOPD: defined as post-bronchodilator FEV1/FVC ratio < LLN. ^bBronchodilator responsiveness: defined as significant bronchodilator response in FEV1 or FVC. ^cPossible restriction: defined as FEV1/FVC ratio ≥ LLN and FVC < 80% predicted value. ^dPreserved Ratio Impaired Spirometry (PRISm): defined as FEV1/FVC ratio ≥ LLN and FEV1 < LLN. Inpatients: participants admitted to hospital. Outpatients: participants not admitted to hospital.

Abbreviations: FEV1, forced expiratory volume-one second; FVC, forced vital capacity; LLN, lower limit of normal.

Figure 1 Density (frequency) distribution of FEV1 by smoking status (A), degree of indoor woodfire exposure (B), BMI (C) and betel nut use (D).

Figure 2 Density (frequency) distribution of FVC by smoking status (A), degree of indoor woodfire exposure (B), BMI (C) and betel nut use (D).

Figure 3 Density (frequency) distribution of FEV1/FVC by smoking status (A), degree of indoor woodfire exposure (B), BMI (C) and betel nut use (D).

Table 3 Emergency Patient Demographics

	“Fast Track” Patients	Emergency Doctor Patients
Average Age	23.9 years (range 1–71)	34.0 years (range 1–82)
Total	120 (62 female, 57 male)	136 (77 female, 55 male)
Sex not Recorded	1 (0.8%)	4 (2.9%)
Paediatric Patients (< 16 years)	48 (40.0%)	36 (26.5%)
Age > 65 years	1 (0.8%)	13 (10.0%)

Notes: Fast Track: “fast track” patients – less-acute patients that are managed by nursing staff. Patients self-triage to fast track.

Figure 4 Adult patients seen in emergency by presentation (%). Note some adult patients had more than one presenting issue.

Figure 5 Paediatric patients seen in emergency by presentation (%).