Epidemiology of lower extremity artery disease in a rural setting of Sub-Saharan Africa: the TAHES study.
Résumé
Background: Data on epidemiology of lower extremity artery disease (LEAD) in general population in Sub-Saharan Africa (SSA) are sparse.
Purpose: This study aims to estimate the prevalence of LEAD among participants of TAHES, a cohort about cardiovascular diseases (CVD) in a rural setting in SSA.
Methods: The cohort was launched since 2015 among adults aged over 25 years based on daily follow up for recording events and annual visit for global evaluation. Ankle-brachial index (ABI) was measured for the first time during the third visit in 2017. Data about risk factors were collected using the WHO STEPS adapted questionnaire in a systematic door-to-door survey. The LEAD was defined as ABI <0.90.
Results: We recorded ABI among 1003 out of 1407 TAHES' participants. A predominance of females (61.4%) was observed. The mean age was 44.4+15.6 years and 49.9% were under 40 years. Regarding CVD risk factors, prevalence were estimated for sedentary behavior (68.2%), alcohol consumption (43.5%), low intake of fruit and vegetable (4.0%), tobacco smoking (5.2%), Overweight or obesity (BMI>25) (27.7%), raised blood pressure (36.8%) and raised blood glucose (5.4%). Prevalence of LEAD was estimated at 5.5% (95% CI: 4.2%-7.1%) for all, 7.0% (95% CI: 5.1%-9.4%) for women and 3.1% (95% CI: 1.7%-5.5%) for men. Five individuals (0.5%; 95% CI: 0.2%-1.2%) had incompressible arteries (ABI >1.40), including four men. In multivariate analysis, LEAD was significantly associated with age >55 years (OR: 2.17; p=009) and female gender (OR: 2.00; p=0.04).
Conclusion: Prevalence of LEAD is high in this population and predominates among women and people over 55 years old.