Prevalence and risk factors of lower extremity disease in high risk groups in Malawi: a stratified cross-sectional study.

Autor:	Kasenda S; Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi., Crampin A; Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi.; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK., Davies J; Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa j.davies.6@bham.ac.uk.; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.; Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa., Malava JK; Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi., Manganizithe S; Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi., Kumambala A; Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi., Sandford B; Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Aug 10; Vol. 12 (8), pp. e055501. Date of Electronic Publication: 2022 Aug 10.
DOI:	10.1136/bmjopen-2021-055501
Abstrakt:	Objective: Low/middle-income countries face a disproportionate burden of cardiovascular diseases. However, among cardiovascular diseases, burden of and associations with lower extremity disease (LED) (peripheral arterial disease and/or neuropathy) is neglected. We investigated the prevalence and factors associated with LED among individuals known to have cardiovascular disease risk factors (CVDRFs) in Malawi, a low-income country with a significant prevalence of CVDRFs. Design: This was a stratified cross-sectional study. Setting: This study was conducted in urban Lilongwe Area 25, and the rural Karonga Health and Demographic Surveillance Site. Participants: Participants were at least 18 years old and had been identified to have two or more known CVDRFs. Main Outcome Measures: LED-determined by the presence of one of the following: neuropathy (as assessed by a 10 g monofilament), arterial disease (absent peripheral pulses, claudication as assessed by the Edinburgh claudication questionnaire or Ankle Brachial Pulse Index (ABPI) <0.9), previous amputation or ulceration of the lower limbs. Results: There were 806 individuals enrolled into the study. Mean age was 52.5 years; 53.5% of participants were men (n=431) and 56.7% (n=457) were from the rural site. Nearly a quarter (24.1%; 95% CI: 21.2 to 27.2) of the participants had at least one symptom or sign of LED. 12.8% had neuropathy, 6.7% had absent pulses, 10.0% had claudication, 1.9% had ABPI <0.9, 0.9% had an amputation and 1.1% had lower limb ulcers. LED had statistically significant association with increasing age, urban residence and use of indoor fires. Conclusions: This study demonstrated that a quarter of individuals with two or more CVDRFs have evidence of LED and 2.4% have an amputation or signs of limb threatening ulceration or amputation. Further epidemiological and health systems research is warranted to prevent LED and limb loss. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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