학술논문
Prevalence of atrial fibrillation in Northern Sri Lanka: a study protocol for a cross-sectional household survey
Document Type
article
Author
Kate Jolly; Gregory Y H Lip; Krishnarajah Nirantharakumar; Hao Wang; Hui Zhang; Abi Beane; Rashan Haniffa; David Moore; Sheila Greenfield; Sue Jowett; Peter Brocklehurst; Isabela M Bensenor; Paulo A Lotufo; Semira Manaseki-Holland; Jingya Wang; Alessandra C Goulart; Trudie Lobban; Deirdre A Lane; Emma Lancashire; Kar Keung Cheng; Yutao Guo; Xuewen Li; Itamar S Santos; Mei Feng; Alena Shantsila; Graham Neil Thomas; Chamira Kodippily; Shribavan Kanesamoorthy; Vethanayagam Antony Sheron; Powsiga Uruthirakumar; Balachandran Kumarendran; Tiffany E Gooden; Mahesan Guruparan; Rajendra Surenthirakumaran; Kumaran Subaschandran; Ajini Arasalingam; Wahbi El-Bouri; Gustavo Gusso; Lindsey Humphreys; Yan-guang Li; Rodrigo D Olmos; Elisabete Paschoal; Paskaran Pirasanth; Carla Romagnolli; Isabelle Szmigin; Abi Meihui Tai; Timo Tolppa; Ana C Varella; Jiaoyue Zhong
Source
BMJ Open, Vol 12, Iss 11 (2022)
Subject
Language
English
ISSN
2044-6055
Abstract
Introduction Atrial fibrillation (AF) is the most common arrhythmia globally. It is associated with a fivefold risk in stroke, but early diagnosis and effective treatment can reduce this risk. AF is often underdiagnosed, particularly in low-income and middle-income countries (LMICs) where screening for AF is not always feasible or considered common practice in primary care settings. Epidemiological data on AF in LMICs is often incomplete particularly in vulnerable populations. This LMIC research collaborative aims to identify the prevalence of AF in the Northern Sri Lankan community.Methods and analysis A cross-sectional household survey piloted and codesigned through a series of community engagement events will be administered in all five districts in Northern Province, Sri Lanka. A multistage cluster sampling approach will be used starting at district level, then the Divisional Secretariats followed by Grama Niladhari divisions. Twenty households will be selected from each cluster. The study aims to recruit 10 000 participants aged 50 years or older, 1 participant per household. Demographic and socioeconomic characteristics, well-being and lifestyle and anthropometric measurements will be collected using a digital data platform (REDCap, Research Electronic Data Capture) by trained data collectors. Participants will be screened for AF using a fingertip single-lead ECG via a smartphone application (AliveCor) with rhythm strips reviewed by a consultant cardiologist. Prevalence of AF and risk factors will be established at province and district-levels. Adjusted ORs and population attributable fractions for AF risk factors will be determined.Ethics and dissemination This study was approved by the Ethics Review Committee of Faculty of Medicine at University of Jaffna. Written informed consent will be obtained from all participants. Findings will be disseminated through publication in a peer-reviewed journal and presentations at conferences. The findings will enable early treatment for new AF diagnoses and inform interventions to improve community-based management of AF in LMICs.