A Pilot Study on the Prevalence of Peripheral Arterial Disease in Kigali, Rwanda

Abstract

Abstract Background Peripheral arterial disease (PAD) has significant morbidity including limb loss. The prevalence of PAD in low- and middle-income countries ranges from 3-25% though the global burden is accepted to be near 6%. The objective of this pilot study was to estimate the prevalence of PAD and associated risk factors in Kigali, Rwanda. Methods This is a multicenter, mixed-methods, cross-sectional study conducted at three health facilities in Kigali, Rwanda. Patients older than 40 years old presenting for non-emergent reasons at the clinics were eligible for participation in the study. An ankle-brachial index (ABI) was measured using the Unetixs Revo 1100/8 MHz probe for PAD screening. An ABI </=0.9 was the value diagnostic for PAD, and >1.3 was used for an inconclusive ABI. A self-reported survey was collected to determine demographics and medical history, including smoking status and medication use. Results A total of 861 participants were included in this study with an overall PAD positivity rate of 3.14%. Additionally, 166 patients (19.3%) had inconclusive ABIs. Patients who screened positive for PAD were significantly more likely to be older (63 vs 56, p = 0.009), of lower wealth indexes (p = 0.016), and were more likely to be current or former smokers (13 (48.1%) vs 217 (32.5%), p = 0.041) (Table 1). Patients with inconclusive ABIs were significantly more likely to be male (70 (42%) vs 140 (21%), p = <0.001), more likely to have chronic kidney disease (4 (2.4%) vs 2 (0.3%), p = 0.016), and more likely to be positive for human immunodeficiency virus (HIV) (44 (27%) vs 127 (19%), p = 0.041). There were also lower rates of DM and HTN in the inconclusive group but no differences in the diagnostic group. Conclusions Our results revealed that the prevalence of PAD in Kigali, Rwanda, was similar to ranges quoted in the literature at 3.14%. Results hint that traditional risk factors such as DM and HTN may be less common amongst people with PAD in Rwanda. Key messages • The prevalence of peripheral artery disease (PAD) in Rwanda is similar to estimates in other LMICs. • Traditional risk factors such as diabetes and hypertension may play smaller roles in the etiology of peripheral artery disease (PAD) in Rwanda.