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Open Access Highly Accessed Research article

Prevalence of lower extremity Peripheral artery disease among adult diabetes patients in Southwestern Uganda

Samson Okello1*, Alexander Millard2, Rogers Owori1, Stephen Bambeiha Asiimwe3, Mark Jacob Siedner4, Joselyn Rwebembera1, Laurence Anthony Wilson1, Christopher Charles Moore2 and Brian Herb Annex25

Author Affiliations

1 Department of Medicine, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda

2 Department of Medicine, University of Virginia, Charlottesville, Virginia, USA

3 Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda

4 Harvard Medical School, Boston, Massachusetts, United States of America

5 The Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, Virginia, USA

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BMC Cardiovascular Disorders 2014, 14:75  doi:10.1186/1471-2261-14-75

Published: 10 June 2014

Abstract

Background

Peripheral artery disease (PAD) is a major complication of atherosclerosis. PAD can be diagnosed with low-cost diagnostic techniques and is associated with significant morbidity and mortality. While the major epidemiologic risk factors for PAD have been established in the western world, data from resource-poor countries are limited. We performed a cross-sectional study to determine the prevalence and correlates of PAD among patients with diabetes at Mbarara Referral Hospital in southwestern Uganda.

Methods

We consecutively enrolled diabetes patients aged 50 years or greater presenting to the outpatient clinic. We collected blood for fasting lipid profile, HIV serology, and glycosylated hemoglobin, measured blood pressure and ankle brachial index, and administered the Edinburgh Claudication Questionnaire (ECQ). We also surveyed patients for other PAD risk factors. We used logistic regression to determine correlates of PAD.

Results

We enrolled 229 diabetes patients. The median age of 60 years (IQR 55–66), and 146 (63.7%) were female. Fifty five patients (24%) had PAD (ABI of ≤ 0.9). Of these, 48 /55 (87.27%) had mild PAD (ABI 0.71-0.9) while 7/55 (12.73%) had moderate to severe PAD (ABI < 0.7). Amongst those with PAD, 24/55 (43.64%) reported claudication by the ECQ. Correlates of PAD included female sex (AOR 2.25, 95% CI 1.06 - 4.77, p = 0.034), current high blood pressure (AOR 2.59, 95% CI 1.25-5.33, p = 0.01), and being on a sulfonylurea–glibenclamide (AOR 3.47, 95% CI 1.55 - 7.76, p = 0.002).

Conclusion

PAD was common in diabetic patients in southwestern Uganda. Given its low cost and ease of measurement, ABI deserves further assessment as a screening tool for both PAD and long term cardiovascular risk amongst diabetics in this region.