LED Lower Extremity Disease in Sub-Saharan Africa: Healthcare Development to prevent Limb Loss 2018 Lilongwe

There is a recognized and increasing burden of non-communicable disease affecting populations in sub-Saharan Africa and cardiovascular disease forms a large part of this health problem. Although coronary artery disease has been studied in this context, there has been little investigation of lower extremity disease (peripheral artery disease and diabetic foot disease) despite the associated risks of ulceration, gangrene, amputation with resulting disability and premature death amongst those affected.
This study was aimed at investigating those at most risk of lower extremity disease in order to identify those showing signs of disease who are not yet symptomatic, to gauge the burden of symptomatic disease, assess the contribution of risk factors for the condition, assess mortality from the condition, and capture access to appropriate healthcare facilities. The study also evaluated the most significant associated risk factors for lower extremity disease.

The study population was individuals from Area 25 in Lilongwe and Chilumba in Karonga with a combination of risk factors (hypertension, diabetes, smoking, obesity or hypercholesterolaemia) in the baseline study of non-communicable disease (NCD).

, In depth questionnaires and basic clinical measurements were used to ascertain presence of LED. Additional data on risk factors was gathered and data were linked to the original NCD survey. Participants who had died had cause of death ascertained through verbal autopsy (in Lilongwe this was carried out as part of the LED study, in Karonga these were already being carried out routinely as part of the DSS).

NHSRC approval number: 2090