Non Valvular Atrial Fibrillation Related Ischaemic Stroke at the Teaching Hospital of Yalgado Ouédraogo, Burkina Faso

Germain, i D; Andre, Samadoulougou K; Aristide, Yaméogo R; Georges, Millogo Rc; Temoua, Naibe D; Hervé, Kaboré Pk; Jonas, Kologo K; Zabsonré, Patrice

doi:10.4172/2329-6925.1000171

Cited by 4 publications

(7 citation statements)

References 28 publications

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“…AF prevalence is low in the general population of SSA at <1% and increases with age [3,15,16], 3-7% in hospital cardiology admissions or newly diagnosed cardiovascular diseases [17][18][19][20][21], 16-22% in heart failure patients [22,23], 10-14% in newly diagnosed and 18-28% in established rheumatic heart disease (RHD) patients [24][25][26], 25% in patients with tuberculous pericarditis [27], 6% de novo cases post-cardiac surgery [28], 9.5% in pregnant women with structural heart disease [29], 2-10% of de novo stroke patients [30][31][32][33], and varies between 25-65% in patients attending oral anti-coagulation clinics in SSA [34][35][36]. In SSA there is a high proportion of permanent AF (12-81.4% across studies) and persistent AF (9.6-70.6%), compared to prevalence of paroxysmal AF (8.9-50%) [20,[37][38][39][40][41] as shown in Table 1. Prominent risk factors or comorbidities associated with AF/AFL in SSA are hypertension, which is observed in 50-87% of cases, heart failure 32-64%, diabetes 4-63%, RHD 15-38%, dilated cardiomyopathy 16-38%, stroke 3-40%, and CAD 1.2-26% of AF/AFL patients ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Despite the relatively lower prevalence of AF in people of African descent, the presence of AF is associated with higher rates of strokes, heart failure, and mortality compared to Caucasians, and Black patients with AF are much younger than patients of other races [123]. Atrial fibrillation was seen in 43-82% of patients with cardio-embolic strokes in SSA [40,46]. Uncontrolled hypertension, low use of anticoagulation due less access and high costs (especially non-vitamin K-dependent oral anticoagulants) and poor time in the therapeutic range among patients on vitamin K-dependent oral anticoagulants, low use of heart failure medication, and late presentation with complications are plausible reasons for this increased risk of adverse outcomes.…”

Section: Atrial Fibrillation/atrial Fluttermentioning

confidence: 99%

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A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Yuyun

Bonny

et al. 2020

Global Heart

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Major structural cardiovascular diseases are associated with cardiac arrhythmias, but their full spectrum remains unknown in sub-Saharan Africa (SSA), which we addressed in this systematic review. Atrial fibrillation/atrial flutter (AF/AFL) prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, but <1% in the general population. Use of oral anticoagulation is heterogenous (9-79%) across SSA. The epidemiology of sudden cardiac arrest/death is less characterized in SSA. Cardiopulmonary resuscitation is challenging, owing to low awareness and lack of equipment for life-support. About 18% of SSA countries have no cardiac implantable electronic devices services, leaving hundreds of millions of people without any access to treatment for advanced bradyarrhythmias, and implant rates are more than 200-fold lower than in the western world. Management of tachyarrhythmias is largely noninvasive (about 80% AF/AFL via rate-controlled strategy only), as electrophysiological study and catheter ablation centers are almost non-existent in most countries. Highlights:-Atrial fibrillation/flutter prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, and <1% in the general population in sub-Saharan Africa (SSA).-Rates of oral anticoagulation use for CHA2DS2VASC score ≥2 are very diverse (9-79%) across SSA countries.-Data on sudden cardiac arrest are scant in SSA with low cardiopulmonary resuscitation awareness.-Low rates of cardiac implantable electronic devices insertions and rarity of invasive arrhythmia treatment centers are seen in SSA, relative to the high-income countries.

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Section: Resultsmentioning

confidence: 99%

Section: Atrial Fibrillation/atrial Fluttermentioning

confidence: 99%

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Yuyun

Bonny

et al. 2020

Global Heart

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“…Only 5.26% of patients who should benefit from OAC received VKA. The OAC prescription rate in patients with AF is very contrasting but globally low in SSA [4, 7, 11, 22, 23, 29] compared with data from Europe with over 80% of eligible patients being anticoagulated [30]. Constraints on OAC prescription in our site comprised financial aspects, difficulties in monitoring INRs, particularly geographic access.…”

Section: Discussionmentioning

confidence: 99%

“…Hospital-based studies revealed that the prevalence of AF in SSA is ranging from 4.6 to 10.6% [4–7]. AF is strongly associated with an increased morbidity, such as stroke/systemic embolism or heart failure [8–11], and high risk of mortality [2, 11]. Healthcare systems in SSA are also characterized by limitations in human and financial resources and geographical access [12].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and long-term prognosis of atrial fibrillation in rural African patients

et al. 2019

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BackgroundFew studies have addressed the pattern of atrial fibrillation (AF) in rural Africa. The purpose of the study was to assess the epidemiology and long-term prognosis of AF in rural African patients in the Regional Hospital Center (RHC) of Tenkodogo, Burkina Faso.ResultsOverall, 107 of 1805 cardiac cases presented with AF (prevalence of 5.9%). Six patients were excluded. Mean age was 66.56 ± 14.92 years, and 53.47% were female. Hypertension was the most prevalent cardiovascular risk factor (59.41%). Congestive heart failure (HF) was reported in 85.15% of the study patients at presentation. Most of the study population presented with severe underlying heart disease (93.1%), and hypertensive heart disease was the most prevalent with 45.54% of the cases. The mean CHA2DS2VASc score in patients with non-valvular heart disease (n = 91) was 3.33 ± 1.25 (extremes 1–6) while the risk of bleeding was low (HAS-BLED score ≤ 1) in 82 patients (81.2%). Oral anticoagulation was prescribed in few cases (5.26%). During a follow-up period of 74.43 ± 23.94 weeks, acute HF and stroke occurred in respectively 43 and 6 patients. Forty-one patients (40.59%) died. The overall survival rate was 69% at 6-month and 59.4% at 1-year follow-up. Patients with idiopathic dilated cardiomyopathy were at higher risk of death than other patients (log-rank test = 11.88, p < 0.001) over time.ConclusionAF is not rare in rural African patients and is associated with an increased long-term risk of HF, stroke, and mortality.

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“…Besides, never screened people could not be respectful with the healthy lifestyle behaviours [28], such as the practice of physical activity, fruit and vegetables consumption, abstention to the alcohol/tobacco use, etc. It can be hypothesized that this level of unknown hypertension may contribute to the high number of surprising cardiocerebrovascular events recorded in Burkina Faso hospital setting: in 58%; 66%; 76% and 86% of patients with respectively acute coronary syndromes [29] cardioembolic disorders [30] stroke [31] and non-valvular atrial brillation [32], hypertension was reported.…”

Section: Discussionmentioning

confidence: 99%

Can low anthropometric features contribute to the non-screening for hypertension among adults in Burkina Faso: Results from the secondary analysis using the database of the 2013 WHO STEPS survey

Diendéré¹,

Rouamba²,

Kaboré³

et al. 2022

Preprint

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Background This paper compared the anthropometric and blood pressure features between the adults who have ever and never been screened for hypertension prior to the first WHO’ Stepwise approach to Surveillance (STEPS) survey in Burkina Faso and assessed the associated factors with the uptake of the hypertension screening. Methods This was a secondary analysis using primary data from a cross-sectional study which were obtained from the 2013 STEPS survey conducted in Burkina Faso. We included 3831 men and women aged 25–64 years. Descriptive and analytical analyses were performed using Student’s t, and chi-square tests and logistic regression models respectively. Results Before the survey, 41.6% of participants have never been screened for hypertension, and comparatively to those who have ever been screened, they had significant lower means of weight, waist circumference and body mass index and lower prevalences of overweight/obesity and abdominal obesity. The prevalence of prehypertension was similar between in the two groups (41.6% in those who have never been screened vs 39.5%; p=0.19) whereas that of hypertension was lower in those who have never been screened (17.3% vs 20.8%; p=0.007). In addition to the important socio-demographic correlates in the logistic regression, the presence of both overweight/obesity (aOR=1.3; p=0.03) and abdominal obesity (aOR=1.3; p=0.002) were significantly associated with the uptake of hypertension screening. Conclusion Prehypertension and hypertension were also frequent in adults who had never been screened for hypertension and they usually had a slim-looking build, while the overweight/obesity and abdominal obesity status may motivate for the uptake of the hypertension screening.

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Non Valvular Atrial Fibrillation Related Ischaemic Stroke at the Teaching Hospital of Yalgado Ouédraogo, Burkina Faso

Cited by 4 publications

References 28 publications

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Epidemiology and long-term prognosis of atrial fibrillation in rural African patients

Can low anthropometric features contribute to the non-screening for hypertension among adults in Burkina Faso: Results from the secondary analysis using the database of the 2013 WHO STEPS survey

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