Prevalence of atrial fibrillation in Northern Sri Lanka: a study protocol for a cross-sectional household survey. Issue 11 (23rd November 2022)

• Record Type: Journal Article
• Authors: Kanesamoorthy, Shribavan; Sheron, Vethanayagam Antony; Uruthirakumar, Powsiga; Kodippily, Chamira; Kumarendran, Balachandran; Gooden, Tiffany E; Thomas, Graham Neil; Nirantharakumar, Krishnarajah; Lip, Gregory Y H; Guruparan, Mahesan; Haniffa, Rashan; Surenthirakumaran, Rajendra; Beane, Abi; Subaschandran, Kumaran
• Other Names: author non-byline.; Arasalingam Ajini author non-byline.; Bensenor Isabela M author non-byline.; Brocklehurst Peter author non-byline.; Cheng Kar Keung author non-byline.; El-Bouri Wahbi author non-byline.; Feng Mei author non-byline.; Goulart Alessandra C author non-byline.; Greenfield Sheila author non-byline.; Guo Yutao author non-byline.; Gusso Gustavo author non-byline.; Humphreys Lindsey author non-byline.; Jolly Kate author non-byline.; Jowett Sue author non-byline.; Lancashire Emma author non-byline.; Lane Deirdre A author non-byline.; Li Xuewen author non-byline.; Li Yan-guang author non-byline.; Lobban Trudie author non-byline.; Lotufo Paulo A author non-byline.; Manaseki-Holland Semira author non-byline.; Moore David author non-byline.; Olmos Rodrigo D author non-byline.; Paschoal Elisabete author non-byline.; Pirasanth Paskaran author non-byline.; Romagnolli Carla author non-byline.; Santos Itamar S author non-byline.; Shantsila Alena author non-byline.; Szmigin Isabelle author non-byline.; Tai Abi Meihui author non-byline.; Tolppa Timo author non-byline.; Varella Ana C author non-byline.; Wang Hao author non-byline.; Wang Jingya author non-byline.; Zhang Hui author non-byline.; Zhong Jiaoyue author non-byline.;
• Is Part Of: BMJ open. Volume 12:Issue 11(2022)
• Publication Date: 2022-11-23
• Subjects: cardiac epidemiology -- telemedicine -- adult cardiology -- cardiology -- statistics & research methods -- preventive medicine; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-056480
• Languages: English
• ISSNs: 2044-6055

Abstract

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.