Background
Screening for atrial fibrillation (AF), a main risk factor for
stroke this is at the upward push in Africa, is turning into increasingly more
crucial.
Objectives
This take a look at sought to observe the feasibility of the
usage of cell electrocardiogram (ECG) recording generation to detect AF.
Methods
In this prospective observational observe, we used a mobile
ECG recorder to screen 50 African adults (sixty six% women; suggest age fifty
four.3 ± 20.Five years) attending Kijabe Hospital (Kijabe, Kenya). Five health
facility health carriers involved in this have a look at's statistics
collection manner also completed a self-administered survey to achieve facts on
their get admission to to the Internet and cellular gadgets, each elements
vital to put into effect ECG cellular era. Outcome measures included feasibility
(of entirety of the study and recruitment of the patients at the deliberate
look at time frame) and the yield of the screening through the cell ECG
technology (ability to come across previously undiagnosed AF).
Results
Patients had been recruited in a 2-week duration as planned;
most effective 1 of the fifty one sufferers approached refused to participate
(ninety eight% reputation rate). All of the 50 patients who agreed to
participate finished the check and produced readable ECGs (one hundred% study
of entirety price). ECG tracings of four of the 50 patients who completed the
have a look at confirmed AF (8% AF yield), and none have been formerly
recognized with AF. When asked approximately non-stop get admission to to
Internet and personal cell gadgets, almost all of the fitness care companies
surveyed spoke back affirmatively.
Conclusions
Using cellular ECG era in screening for AF in low-useful
resource settings is viable, and may discover a great proportion of AF cases in
an effort to otherwise move undiagnosed. Further have a look at is wanted to
take a look at the fee-effectiveness of this technique for detection of AF and
its impact on lowering the threat of stroke in growing nations.
Section snippets
Methods
This observe turned into performed at Kijabe Hospital, a
Christian undertaking health center in association with the African Inland
Church. It is placed 50 km northwest of Nairobi, Kenya, in a rural network that
become at the start a assignment station. Kijabe Hospital in the main serves
the Kiambu, Nakuru, and Nyadarua districts of Kenya .
The purpose of the examine changed into to recruit 50
patients in a 2-week length. Several health care clinics have been targeted
that have been in all likelihood to yield patients at expanded risk for AF.
These
Results
A general of fifty one patients had been approached from
July 12 to 23, 2016, of which 50 (98%) had been willing to participate and
signal a consent shape. Characteristics of the have a look at population are
shown in Table 1. Most individuals had been ladies, and most were recruited
from the outpatient inner medicine or diabetes clinics. More than forty% of the
sufferers had high blood pressure, and almost one-1/3 had type 2 diabetes.
Other scientific conditions had been much less common.
Out of the 50 whole ECGs, the automated diagnostic
Discussion
Africa is presently undergoing an epidemiological transition
straining its fitness care infrastructure. The incidence of noninfectious
diseases is growing, mortality prices are lowering, and there's a concomitant
population boom, fueled by using urban industrialization and increasing
exposure to Western diet and lifestyle 1, eleven. With communicable sicknesses
(e.G., tuberculosis and human immunodeficiency virus) nevertheless now not
absolutely under manipulate, this transition places a double burden on Africa's
health
Conclusions
We confirmed that the cellular ECG can be applied
efficiently in low-useful resource settings to display screen for AF by way of
fitness care providers. Further take a look at is wanted to have a look at the
fee-effectiveness of this technique for detection of AF and its impact on
decreasing the threat of stroke in developing international locations.
Acknowledgments
The authors thank the following people for precious help
with planning for this study and records collection at the AIC Kijabe Hospital:
Jonathan Matson, MD (emergency medicinal drug), Julius Kimotho, and George
Mburu (Head Clinical Officers, Outpatient Diabetes Clinic). The authors also
thank Lynne Wagenknecht, DrPH (Wake Forest School of Medicine), for her
guidance inside the inception and design.
