title: Peripheral Arterial Disease in Sub-Saharan Africa: A Review.
abstract: Peripheral arterial disease (PAD) causes significant morbidity and is an important risk factor for cardiovascular disease-related mortality. However, the burden of PAD in sub-Saharan Africa is poorly understood.
  
  
  
  To assess epidemiological and clinical reports regarding PAD from sub-Saharan Africa such that the regional epidemiology and management of PAD could be described and recommendations offered.
  
  
  
  A systematic search in PubMed, Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, and Google Scholar for reports pertaining to the epidemiology and/or management of PAD in sub-Saharan Africa was performed. Reports that met inclusion criteria were sorted into 3 categories: population epidemiology, clinical epidemiology, and surgical case series. Findings were extracted and described.
  
  
  
  The search returned 724 records; of these, 16 reports met inclusion criteria. Peripheral arterial disease epidemiology and/or management was reported from 10 of the 48 sub-Saharan African countries. Peripheral arterial disease prevalence ranged from 3.1% to 24% of adults aged 50 years and older and 39% to 52% of individuals with known risk factors (eg, diabetes). Medical management was only described by 2 reports; both documented significant undertreatment of PAD as a cardiovascular disease risk factor. Five surgical case series reported that trauma and diabetes-related complications were the most common indications for vascular surgery.
  
  
  
  The prevalence of PAD in sub-Saharan Africa may be equal to or higher than that in high-income countries, exceeding 50% in some high-risk populations. In addition to population-based studies that better define the PAD burden in sub-Saharan Africa, health systems should consider studies and action regarding risk factor mitigation, targeted screening, medical management of PAD, and defining essential vascular care.
authors.affiliation: Department of Surgery, University of Virginia, Charlottesville2Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Lily E
authors.initials: LE
authors.lastname: Johnston
authors.affiliation: Department of Surgery, University of Washington, Seattle4Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana5Komfo Anokye Teaching Hospital, Kumasi, Ghana6Department of Interdisciplinary Hea.
authors.forename: Barclay T
authors.initials: BT
authors.lastname: Stewart
authors.affiliation: Department of Surgery, University of Bouake, Bouake, Cote d'Ivoire.
authors.forename: Herve
authors.initials: H
authors.lastname: Yangni-Angate
authors.affiliation: Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Martin
authors.initials: M
authors.lastname: Veller
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, University of Virginia, Charlottesville.
authors.forename: Gilbert R
authors.initials: GR
authors.lastname: Upchurch
authors.affiliation: Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana5Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Adam
authors.initials: A
authors.lastname: Gyedu
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland11Surgeons OverSeas, New York, New York12Department of Surgery, Columbia University, New York, New York.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Kushner
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D000367:Age Factors; D006306:Health Surveys; D006801:Humans; D058729:Peripheral Arterial Disease / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D015995:Prevalence; D012307:Risk Factors