Prevalence and risk factors of lower extremity disease in high risk groups in Malawi: a stratified cross-sectional study
| dc.contributor.author | Stephen Kasenda | |
| dc.contributor.author | Amelia Crampin | |
| dc.contributor.author | Justine Davies | |
| dc.contributor.author | Jullita Kenala Malava | |
| dc.contributor.author | Stella Manganizithe | |
| dc.contributor.author | Annie Kumambala | |
| dc.contributor.author | Becky Sandford | |
| dc.date.accessioned | 2024-04-01T19:40:24Z | |
| dc.date.available | 2024-04-01T19:40:24Z | |
| dc.date.issued | 2022-10-10 | |
| dc.description.abstract | 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. | |
| dc.description.librarian | PM2023 | |
| dc.faculty | Faculty of Health Sciences | |
| dc.identifier.uri | https://hdl.handle.net/10539/38269 | |
| dc.language.iso | en | |
| dc.school | Public Health | |
| dc.subject | cardiac epidemiology; cardiology; epidemiology; hypertension. | |
| dc.title | Prevalence and risk factors of lower extremity disease in high risk groups in Malawi: a stratified cross-sectional study | |
| dc.type | Article |