Burden of Peripheral Artery Disease in Sub-Saharan Africa and the Caribbean 1990 to 2015

Abstract

Background:

The estimated global prevalence of Peripheral artery disease (PAD) increased by 24% in span of 10 years (2000-2010) from 164 to 202 million. Despite scarcity of data on PAD in sub-Saharan Africa (SSA) and the Caribbean, estimates for PAD from these regions may be helpful for health-care providers.

Methods:

The Global Burden of Disease Study 2015 quantified health loss from hundreds of diseases using systematic reviews and multilevel computer modeling. Estimated rates with 95% uncertainty intervals (UI) for PAD (ICD-10 I70.2) were examined for SSA and the Caribbean and compared to high-income North America (HINA). Disability-adjusted life years (DALYs) are years of healthy life lost representing total disease burden by combining years of life lost and years lived disabled.

Results:

In 2015, estimated age-standardized DALYs per 100,000 due to PAD for males were as follows: Caribbean (34, UI: 29-39), HINA (36, UI: 30-42), and SSA (20, UI: 14-30). In contrast, DALYs in females were as follows: Caribbean (25, UI: 20-30), HINA (28, UI: 22-36), and SSA (17, UI: 11-26). For both sexes combined, the rate in Southern SSA was 55 (46-67). This reflects the extremely high rates in South Africa (males 90, UI: 77-107; females 63, UI: 53-75).

Conclusion:

Estimated rate of DALYs per 100,000 was lowest in SSA. Within SSA, the rate in South Africa was highest, exceeding even HINA. Caribbean rates were intermediate.

Keywords

Peripheral artery disease Sub-Saharan Africa Caribbean High-income

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References

Ofoegbu

Guirguis

. The incidence and pattern of atherosclerosis in Africans. Vasc Surg. 1985;19(2):87–92.

Fowkes

FGR

Rudan

. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013;382(9901):1329–1340.

Forouzanfar

Afshin

Alexander

. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1659–1724.

Abubakar

Tillmann

Banerjee

. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–171.

Pang

Han

. Lower extremity peripheral arterial disease is an independent predictor of coronary heart disease and stroke risks in patients with type 2 diabetes mellitus in China. Int J Endocrinol. 2017;2017:9620513.

Jones

Patel

Dai

. Temporal trends and geographic variation of lower-extremity amputation in patients with peripheral artery disease: results from US Medicare 2000-2008. J Am Coll Cardiol. 2012;60(21):2230–2236.

Murray

Abraham

Ali

. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310(6):591–608.

Vos

Allen

Arora

. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1545–1602.

Kassebaum

Arora

Barber

. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1603–1658.

10.

Wang

Dwyer-Lindgren

Lofgren

. Age-specific and sex-specific mortality in 187 countries, 1970-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2071–2094.

11.

Anon. The Global Burden of Disease: Generating Evidence, Guiding, Policy. Washington: World Bank; 2010.

12.

Yeboah

Puplampu

Ainuson

Akpalu

Gyan

Amoah

. Peripheral artery disease and exertional leg symptoms in diabetes patients in Ghana. BMC Cardiovasc Disord. 2016;16(1):68.

13.

Johnston

Stewart

Yangni-Angate

. Peripheral arterial disease in Sub-Saharan Africa: a review. JAMA Surg. 2016;151(6):564–572.

14.

Desormais

Aboyans

Guerchet

. Prevalence of peripheral artery disease in the elderly population in urban and rural areas of Central Africa: the EPIDEMCA study. Eur J Prev Cardiol. 2015;22(11):1462–1472.

15.

Ngoungou

Aboyans

Kouna

. Prevalence of cardiovascular disease in Gabon: a population study. Arch Cardiovasc Dis. 2012;105(2):77–83.

16.

Okello

Millard

Owori

. Prevalence of lower extremity peripheral artery disease among adult diabetes patients in Southwestern Uganda. BMC cardiovasc disord. 2014;14(1):75.

17.

Guerchet

Aboyans

Mbelesso

. Epidemiology of peripheral artery disease in elder general population of two cities of Central Africa: Bangui and Brazzaville. Eur J Vasc Endovasc Surg. 2012;44(2):164–169.

18.

Moran

Forouzanfar

Sampson

Chugh

Feigin

Mensah

. The epidemiology of cardiovascular diseases in sub-Saharan Africa: the global burden of diseases, injuries and risk factors 2010 study. Prog Cardiovas Dis. 2013;56(3):234–239.

19.

Collins

Slovut

Newton

Jr . Ideal cardiovascular health and peripheral artery disease in African Americans: results from the Jackson heart study. Prev Med Rep. 2017;7:20–25.

20.

Criqui

Vargas

Denenberg

. Ethnicity and peripheral arterial disease: the San Diego Population Study. Circulation. 2005;112(17):2703–2707.

21.

Thorogood

Connor

Tollman

Hundt

Fowkes

Marsh

. A cross-sectional study of vascular risk factors in a rural South African population: data from the Southern African Stroke Prevention Initiative (SASPI). BMC Public Health. 2007;7(1):326.

22.

Paul

Mash

Rupesinghe

. Peripheral arterial disease-high prevalence in rural black South Africans. S Afr Med J. 2007;97(4):285–288.

23.

Rheeder

Van Wyk

Stolk

Grobbee

. Assessing peripheral arteries in South African black women with type 2 diabetes mellitus. J Endocrinol. 2004;9(3):79–83.

24.

Oyelade

OlaOlorun

Amole

Odeigah

Adediran

. The prevalence of peripheral arterial disease in diabetic subjects in south-west Nigeria. Afric J Prim Health Care Family Med. 2012;4(1):1–6.

25.

Mensah

Sampson

Roth

. Mortality from cardiovascular diseases in sub-Saharan Africa, 1990-2013: a systematic analysis of data from the Global Burden of Disease Study 2013: cardiovascular topic. Cardiovas J Africa. 2015;26(suppl 1):6–10.

26.

Roth

Huffman

Moran

. Global and regional patterns in cardiovascular mortality from 1990 to 2013. Circulation. 2015;132(17):1667–1678.

27.

Forouzanfar

Moran

Flaxman

. Assessing the global burden of ischemic heart disease, part 2: analytic methods and estimates of the global epidemiology of ischemic heart disease in 2010. Global Heart. 2012;7(4):331–342.

28.

Moran

Oliver

Mirzaie

. Assessing the global burden of ischemic heart disease, part 1: methods for a systematic review of the global epidemiology of ischemic heart disease in 1990 and 2010. Global Heart. 2012;7(4):315–329.

29.

Ayinde

Gillum

. Cardiovascular disease mortality in Sub-Saharan Africa and the Caribbean. Ethnicity Dis. 2014;24(4):495–501.

30.

Sampson

Engelgau

Peprah

Mensah

. Endothelial dysfunction: a unifying hypothesis for the burden of cardiovascular diseases in sub-Saharan Africa. Cardiovas J Africa. 2015;26(suppl 1):56–60.

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