Prevalence, patterns and factors associated with peripheral arterial disease among patients with intermittent claudication at St. Francis Hospital, Nsambya

Abstract

Background: In Uganda, there is limited information on the prevalence, pattern and factors associated with lower limb PAD. The study was conducted to determine the prevalence, describe patterns and identify factors associated with PAD among patients with intermittent claudication. Materials and methods: This was a retrospective cross-sectional study with analytical component involving review of patients’ records from January 2015 to August 2017 in Radiology Department of Nsambya Hospital using a structured questionnaire. Records and CT angiograms were sampled consecutively until 69 records were obtained. Trained Research Assistants retrieved the records and the PI collected the data. The study was approved by an IRB. The data was entered into EPIINFO version 7.1.2.5 and analyzed with STATA version 13.0. Results: Fifty two (52) out of 69, 75.6% (95% CI: 63.56 – 84.29) participants with intermittent claudication had lower limb PAD. Males and females had similar prevalence i.e. [75.56% (95% CI: 60.55 – 86.16); 75% (95% CI: 53.44 – 88.69)]. Infra-popliteal segment had the largest number (150) of PAD lesions followed by femoro-popliteal segment with 69 arterial lesions and 28 aorto-iliac segmental lesions. Occlusion was the commonest PAD lesion which affected 290 segments, followed by 67 stenotic segments and only 3 segments were affected by aneurysm. Significant stenosis (≥50% lumen narrowing) affected 67 segments and occlusion (290) segments. 11 participants out of 52 fell in TASCII category. Severely affected segments of the lower limb arterial tree had atherosclerosis and collateral arteries. Age group and diabetes were significantly associated with PAD i.e. P value of 0.003 and 0.04 respectively. Conclusion: Lower limb PAD prevalence was high (75.6%) among participants with intermittent claudication in Nsambya Hospital from January 2015 to August 2017. It was comparable among males and females i.e. 75.56% and 75%. Lower limb steno-occlusive disease was the commonest PAD type affecting infra-popliteal vasculature. Anterior tibial artery and superficial femoral arteries were the most severely affected with collateral artery development. Diabetes and increasing age were associated with lower limb PAD while gender and hypertension had no association. Key words: Prevalence, pattern, factors, Peripheral arterial disease and intermittent claudication.