Prevalence and risk factors for atrial fibrillation and its anticoagulant requirement in adults aged ≥40 in Jimma Town, Southwest Ethiopia: A community based cross-sectional study

Abstract

Background There is no information on the prevalence and incidence of atrial fibrillation in Ethiopia. We aimed to investigate the prevalence, risk factors and anticoagulant requirements of atrial fibrillation in an elderly Jimma population. Methods In a community-based cross-sectional study in 634 adult (≥40 years) Jimma population, we performed cardiovascular health examinations including a 12-lead electrocardiogram to estimate AF prevalence. A standardized questionnaire was used to collect information on medical history, lifestyle and use of medications. Stroke risk stratification was done using CHA 2 DS 2 -VASc score. We used logistic regressions to determine the potential risk factors of AF. Results The overall prevalence of AF was 4.3%. AF was associated with sex, current smoking, hypertension and BMI. Nineteen out of twenty seven participants with AF were in need of anticoagulation to prevent risk of stroke. Conclusion The prevalence of AF is high and common risk factors were sex, current smoking, hypertension, and higher BMI in this cohort. More than two-third of study participants with AF were at higher need of oral anticoagulants.

A review of the epidemiology of atrial fibrillation in sub‐Saharan Africa

“…This is lower than the estimates from other regions as shown by two large multinational studies conducted in 19 and 26 countries, that reported a prevalence of diabetes more than 20% in patients with AF . Obesity, another important cardiometabolic risk factor for AF, was barely reported in studies from SSA . Obesity is a growing global epidemic mostly affecting high‐income countries, but increasingly prevalent in low and middle countries including those in SSA .…”

“…Only three studies reported the prevalence of AF in the general population in the community . This prevalence was 4.3%, 0.3%, and 0.7% in individuals aged ≥40 years, aged ≥50 years, and aged ≥70 years in Ethiopia, Ghana, and Tanzania, respectively (Table ).…”

“…Only three studies reported the prevalence of AF in the general population in the community . This prevalence was 4.3%, 0.3%, and 0.7% in individuals aged ≥40 years, aged ≥50 years, and aged ≥70 years in Ethiopia, Ghana, and Tanzania, respectively (Table ). Regarding hospital‐based studies done in individuals without a specified condition, AF was found in 0.7% of patients admitted to the general medical ward in a large study in Kenya (n = 22 144), and in 3% of patients attending general practice in South Africa (n = 9133)…”

“…In the studies reporting on the prevalence of diabetes mellitus in patients with AF, 20,58,59,[66][67][68]71,73 rates were between 2.9% 58 and 33.3%. 20 In three studies, the prevalence of obesity was 48.1% (body mass index [BMI] ≥ 25), 17 5.5% (BMI ≥ 30), 62 and 6.4% (BMI ≥ 35). 73 In most studies, about 20% of patients had cardiomyopathy as the underlying etiologic factor.…”

“…The two studies reporting such data had conflicting findings. Dewhurst et al showed a strikingly low prevalence of AF at 0.7% in individuals aged ≥70 years, whereas Tegene et al reported a prevalence of 4.3% in people aged ≥40 years. Aging being the strongest risk factor for AF, it is surprising to see such a higher prevalence of AF in a much younger population.…”