title: Review of epidemiology and management of atrial fibrillation in developing countries.
abstract: BACKGROUND
  Atrial fibrillation (AF) is the commonest sustained cardiac arrhythmia. In developing countries, AF is a growing public health problem with the epidemiologic transition from communicable to non-communicable diseases. However, relatively little is known about AF in the developing world. The aim of this review is to examine in developing countries the prevalence, associated medical conditions and management of AF.
  
  
  METHODS
  A literature search was conducted via MEDLINE and EMBASE (1990-2012).
  
  
  RESULTS
  Seventy studies were included in the review. The prevalence of AF in the general population ranged from 0.03% to 1.25%, while the prevalence of AF in hospital-based studies varied from 0.7% to 55.7%. Prevalence of AF in Africa was lower than in other regions. The most common conditions associated with AF were hypertension (10.3%-71.9%) and valvular heart disease (5.6%-66.3%). The prevalence of stroke in patients with AF ranged from 6.7% to 27%. The utilization of anticoagulants was highly variable (2.7%-72.7%). Approximately half of the patients with AF using warfarin had therapeutic International Normalized Ratios (INR). There was a high prevalence of use of rate control therapies (55.3%-87.3%).
  
  
  CONCLUSIONS
  The limited studies available suggest that in the developing world there is a significant prevalence of AF, which is predominantly associated with hypertension and valvular heart disease, and carries a risk of stroke. Highly variable use of anticoagulants may be related to different health care and socioeconomic settings. More studies are needed to improve understanding of the epidemiology and management of AF in developing countries.
authors: School of Public Health, University of Sydney, Sydney, NSW, Australia. nngu9517@uni.sydney.edu.au
authors: Tu N
authors: TN
authors: Nguyen
authors: Sarah N
authors: SN
authors: Hilmer
authors: Robert G
authors: RG
authors: Cumming
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000191:economics / Q000453:epidemiology* / Q000628:therapy*; D003906:Developing Countries / Q000191:economics; D019468:Disease Management; D006760:Hospitalization / Q000191:economics; D006801:Humans; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: Antithrombotic therapies; Atrial fibrillation; Developing countries