Affiliation:
1. Warren Alpert Medical School of Brown University
2. University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
3. Department of Surgery, Division of Vascular Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
4. Department of Emergency Medicine
Abstract
Background:
The global burden of peripheral arterial disease (PAD) is high, but few studies have measured the prevalence of PAD in low- and middle-income countries. The objective of this pilot study was to estimate the prevalence of PAD and associated risk factors in a naïve population in Kigali, Rwanda.
Methods:
This is a mixed-methods, cross-sectional study conducted at three health centers in Kigali. Patients meeting the criteria were administered an ankle-brachial index (ABI) and a survey. An ABI </=0.9 was the value diagnostic for PAD and >1.3 was used for an inconclusive ABI. A post hoc analysis stratified by HIV status was conducted.
Results:
A total of 861 participants were included with an overall PAD positivity rate of 3.14%, and 166 patients (19.3%) had inconclusive ABIs. Patients with diagnostic ABIs were more likely to be older (63 vs. 56, P=0.009), of lower wealth indexes (P=0.016), and smokers [13 (48.1%) vs. 217 (32.5%), P=0.041]. Patients with inconclusive ABIs were more likely to be male [70 (42%) vs. 140 (21%), P≤0.001], to have chronic kidney disease [4 (2.4%) vs. 2 (0.3%), P=0.016], and to be positive for HIV [44 (27%) vs. 127 (19%), P=0.041]. People with HIV were more likely to be younger (54 vs. 57, P<0.01) and less likely to have other comorbidities such as diabetes [27 (16%) vs. 171 (25%), P<0.01] and hypertension [57 (33%) vs. 307 (45%), P<0.01].
Conclusions:
The prevalence of PAD in our study’s population was 3.14%. This pilot study identified a comorbid burden for HIV and PAD in Rwanda.
Publisher
Ovid Technologies (Wolters Kluwer Health)