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Year:: 2022
Contributor:: Nussenzweig, Samuel (Author); Dockery, Dominique (Author); Cunningham, Ryan (Author); Allu, Sai (Author); Licht, Aron (Author); Ingabire, Emeline (Author); Josiane, Izere (Author); Philemon, Nisingizwe (Author); Martin, Kyle Denison (Author); Moreira, Carla (Author); Patterson, Robert (Author); Brown University. Alpert Medical School. Scholarly Concentration Program. Non-Scholarly Concentrator (research program)
Subject:: Biology; Medicine; Clinical medicine--Research; World health; Rwanda; Atherosclerosis; Blood-vessels--Diseases

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Abstract:: Introduction: The global burden of peripheral arterial disease (PAD) is estimated to be over 230 million people but few studies have measured the prevalence of PAD in low- and middle-income countries such as Rwanda. Traditionally, research efforts in many African countries were geared towards communicable disease, but recently the tide has shifted to make efforts to reduce noncommunicable disease. 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 centers across 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. 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). 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). Conclusion: Our results revealed that the prevalence of PAD in Kigali, Rwanda was similar to ranges quoted in the literature at 3.14%. There was also a significant number of inconclusive ABIs in our study, potentially due in part to higher rates of HIV in this population. However, our results hint that traditional risk factors such as diabetes and hypertension may hold smaller roles in the etiology of disease in Rwanda. Further studies are needed to evaluate vascular disease in this population and similar countries to help provide supporting evidence for future interventions. Work aimed at primary prevention can help relieve the burden of PAD in this population.
Notes:: Scholarly concentration: Non-Scholarly Concentrator

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Nussenzweig, Samuel, Dockery, Dominique, Cunningham, Ryan, et al., "A Pilot Study on the Prevalence of Peripheral Arterial Disease in Kigali, Rwanda" (2022). Warren Alpert Medical School Academic Symposium. Brown Digital Repository. Brown University Library. https://repository.library.brown.edu/studio/item/bdr:trqt4698/

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Warren Alpert Medical School Academic Symposium

The Warren Alpert Medical School Academic Symposium is an annual event at Warren Alpert Medical School of Brown University that provides Year II medical students a venue to present their summer research in a poster format. Participation in the Symposium …
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A Pilot Study on the Prevalence of Peripheral Arterial Disease in Kigali, Rwanda