Article Text


Validation of the Saint George’s Respiratory Questionnaire in Uganda
  1. Brooks W Morgan1,2,
  2. Matthew R Grigsby1,2,
  3. Trishul Siddharthan1,2,
  4. Robert Kalyesubula3,
  5. Robert A Wise1,2,
  6. John R Hurst4,
  7. Bruce Kirenga3 and
  8. William Checkley1,2,5
  1. 1 Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  2. 2 Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, Maryland, USA
  3. 3 College of Health Sciences, Makerere University, Kampala, Uganda
  4. 4 UCL Respiratory, Division of Medicine, University College London, London, UK
  5. 5 Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr William Checkley; wcheckl1{at}


Introduction Chronic obstructive pulmonary disease (COPD) will soon be the third leading global cause of death and is increasing rapidly in low/middle-income countries. There is a need for local validation of the Saint George’s Respiratory Questionnaire (SGRQ), which can be used to identify those experiencing lifestyle impairment due to their breathing.

Methods The SGRQ was professionally translated into Luganda and reviewed by our field staff and a local pulmonologist. Participants included a COPD-confirmed clinic sample and COPD-positive and negative members of the community who were enrolled in the Lung Function in Nakaseke and Kampala (LiNK) Study. SGRQs were assembled from all participants, while demographic and spirometry data were additionally collected from LiNK participants.

Results In total, 103 questionnaires were included in analysis: 49 with COPD from clinic, 34 community COPD-negative and 20 community COPD-positive. SGRQ score varied by group: 53.5 for clinic, 34.4 for community COPD-positive and 4.1 for community COPD-negative (p<0.001). The cross-validated c statistic for SGRQ total score predicting COPD was 0.87 (95% CI 0.75 to 1.00). SGRQ total score was associated with COPD severity (forced expiratory volume in 1 s per cent of predicted), with an r coefficient of −0.60 (−0.75, −0.39). SGRQ score was associated with dyspnoea (OR 1.05/point; 1.01, 1.09) and cough (1.07; 1.03, 1.11).

Conclusion Our Luganda language SGRQ accurately distinguishes between COPD-positive and negative community members in rural Uganda. Scores were correlated with COPD severity and were associated with odds of dyspnoea and cough. We find that it can be successfully used as a respiratory questionnaire for obstructed adults in Uganda.

  • COPD epidemiology
  • respiratory measurement

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  • Contributors BWM, MRG, TS, RK, JRH, BK, WC and RAW each assisted with the study design and implementation, as well as the writing of the manuscript.

  • Funding This project was supported by NIH Research Training Grant #D43 TW009340 funded by the NIH Fogarty International Center, NINDS, NIMH, NHLBI, and NIEHS, the COPD Discovery Fund from Johns Hopkins University, and the Johns Hopkins Center for Global Health. Analysis of the validation of the SGRQ instrument in Uganda was supported in part by the Medical Research Council (MR/P008984/1, PI: Hurst).

  • Competing interests RAW reports grants and/or personal fees from AstraZeneca/Medimmune, Boehringer Ingelheim, Contrafect, GlaxoSmithKline, Pfizer, Pulmonx, Roche, Spiration, Sunovion, Teva, Pearl Therapeutics, Merck and Bonti outside the submitted work.

  • Patient consent Not required.

  • Ethics approval Johns Hopkins School of Medicine, Makerere University, Uganda National Council for Science and Technology.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Please forward requests for data to Dr Trishul Siddharthan (

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