A Gyedu1,2, B T Stewart1,2,3, E Nakua4, R Quansah1,2, P Donkor1,2, C Mock3,5,6, M Hardy7, K H Yangni-Angate8. 1. Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2. Komfo Anokye Teaching Hospital, Kumasi, Ghana. 3. Departments of Surgery, University of Washington, Washington, USA. 4. School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 5. Departments of Global Health, University of Washington, Washington, USA. 6. Harborview Injury Prevention and Research Center, Seattle, Washington, USA. 7. Department of Surgery, Columbia University College of Physicians and Surgeons, New York, USA. 8. Department of Surgery, Bouake Teaching Hospital, and Department of Thoracic and Cardiovascular Diseases, University of Bouake, Bouake, Ivory Coast.
Abstract
BACKGROUND: This study aimed to describe national peripheral vascular disease (PVD) risk and health burden, and vascular care capacity in Ghana. The gap between PVD burden and vascular care capacity in low- and middle-income countries was defined, and capacity improvement priorities were identified. METHODS: Data to estimate PVD risk factor burden were obtained from the World Health Organization Study on Global Ageing and Adult Health (SAGE), Ghana, and the Institute of Health Metrics and Evaluation Global Burden of Disease (IHME GBD) database. In addition, a novel nationwide assessment of vascular care capacity was performed, with 20 vascular care items assessed at 40 hospitals in Ghana. Factors contributing to specific item deficiency were described. RESULTS: From the SAGE database, there were 4305 respondents aged at least 50 years with data to estimate PVD risk. Of these, 57·4 per cent were at moderate to risk high of PVD with at least three risk factors; extrapolating nationally, the estimate was 1 654 557 people. Based on IHME GBD data, the estimated disability-adjusted life-years incurred from PVD increased fivefold from 1990 to 2010 (from 6·3 to 31·7 per 100 000 persons respectively). Vascular care capacity assessment demonstrated marked deficiencies in items for diagnosis, and in perioperative and vascular surgical care. Deficiencies were most often due to absence of equipment, lack of training and technology breakage. CONCLUSION: Risk factor reduction and management as well as optimization of current resources are paramount to avoid the large burden of PVD falling on healthcare systems in low- and middle-income countries. These countries are not well equipped to handle vascular surgical care, and rapid development of such capacity would be difficult and expensive.
BACKGROUND: This study aimed to describe national peripheral vascular disease (PVD) risk and health burden, and vascular care capacity in Ghana. The gap between PVD burden and vascular care capacity in low- and middle-income countries was defined, and capacity improvement priorities were identified. METHODS: Data to estimate PVD risk factor burden were obtained from the World Health Organization Study on Global Ageing and Adult Health (SAGE), Ghana, and the Institute of Health Metrics and Evaluation Global Burden of Disease (IHME GBD) database. In addition, a novel nationwide assessment of vascular care capacity was performed, with 20 vascular care items assessed at 40 hospitals in Ghana. Factors contributing to specific item deficiency were described. RESULTS: From the SAGE database, there were 4305 respondents aged at least 50 years with data to estimate PVD risk. Of these, 57·4 per cent were at moderate to risk high of PVD with at least three risk factors; extrapolating nationally, the estimate was 1 654 557 people. Based on IHME GBD data, the estimated disability-adjusted life-years incurred from PVD increased fivefold from 1990 to 2010 (from 6·3 to 31·7 per 100 000 persons respectively). Vascular care capacity assessment demonstrated marked deficiencies in items for diagnosis, and in perioperative and vascular surgical care. Deficiencies were most often due to absence of equipment, lack of training and technology breakage. CONCLUSION: Risk factor reduction and management as well as optimization of current resources are paramount to avoid the large burden of PVD falling on healthcare systems in low- and middle-income countries. These countries are not well equipped to handle vascular surgical care, and rapid development of such capacity would be difficult and expensive.
Authors: Evan G Wong; Thaim B Kamara; Reinou S Groen; Cheryl K Zogg; Michael E Zenilman; Adam L Kushner Journal: World J Surg Date: 2015-01 Impact factor: 3.352
Authors: Shelly Choo; Henry Perry; Afua A J Hesse; Francis Abantanga; Elias Sory; Hayley Osen; Charles Fleischer-Djoleto; Rachel Moresky; Colin W McCord; Meena Cherian; Fizan Abdullah Journal: Trop Med Int Health Date: 2010-07-14 Impact factor: 2.622
Authors: Phillipo L Chalya; Joseph B Mabula; Ramesh M Dass; Isdori H Ngayomela; Alphonce B Chandika; Nkinda Mbelenge; Japhet M Gilyoma Journal: J Orthop Surg Res Date: 2012-05-11 Impact factor: 2.359
Authors: Nadia Minicuci; Richard B Biritwum; George Mensah; Alfred E Yawson; Nirmala Naidoo; Somnath Chatterji; Paul Kowal Journal: Glob Health Action Date: 2014-04-15 Impact factor: 2.640
Authors: Barclay T Stewart; Adam Gyedu; Christos Giannou; Brijesh Mishra; Norman Rich; Sherry M Wren; Charles Mock; Adam L Kushner Journal: J Vasc Surg Date: 2016-07-16 Impact factor: 4.268