Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study
Background: In Thailand, almost one-quarter of strokes are related to atrial fibrillation (AF), and many could be prevented if AF were diagnosed and treated prior to the stroke. Therefore, we tested a novel strategy to screen large numbers of community residents using village health volunteers and p...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-02-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906720304073 |
| _version_ | 1818850136710709248 |
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| author | Nijasri C. Suwanwela Aurauma Chutinet Hathairat Autjimanon Tanawat Ounahachok Chumpol Decha-umphai Songkhram Chockchai Saowanin Indrabhakti Naruchorn Kijpaisalratana Wasan Akarathanawat Suporn Travanichakul Teeraparp Kitjavijitre Pakkawan Vongvasinkul Ittaporn Kanacharoen Tanyaluk O. Bunlikitkul Supparat Charnwut Nicole Lowres Ben Freedman |
| author_facet | Nijasri C. Suwanwela Aurauma Chutinet Hathairat Autjimanon Tanawat Ounahachok Chumpol Decha-umphai Songkhram Chockchai Saowanin Indrabhakti Naruchorn Kijpaisalratana Wasan Akarathanawat Suporn Travanichakul Teeraparp Kitjavijitre Pakkawan Vongvasinkul Ittaporn Kanacharoen Tanyaluk O. Bunlikitkul Supparat Charnwut Nicole Lowres Ben Freedman |
| author_sort | Nijasri C. Suwanwela |
| collection | DOAJ |
| description | Background: In Thailand, almost one-quarter of strokes are related to atrial fibrillation (AF), and many could be prevented if AF were diagnosed and treated prior to the stroke. Therefore, we tested a novel strategy to screen large numbers of community residents using village health volunteers and primary care nurses. Methods: Local primary care nurses and village health volunteers in Phetchaburi and Lopburi provinces, Thailand were trained to perform AF screening using a blood pressure device with AF algorithm (Microlife A200 AFib). 10% of residents aged ≥ 65 years were randomly selected for screening during home-visits. Participants with possible AF were given follow-up appointments for further testing, including 12-lead ECG and echocardiogram. Results: Over two-months, 9.7% (13,864/143,478) of the target population were screened: mean age 73.2 ± 6.4 years, 32.4% male. The estimated AF prevalence (detected by Microlife A200 AFib) was 2.8% (95% CI, 2.6–3.1%) for age ≥ 65 years (i.e. 393/13,864 participants). Prevalence increased with age from 1.9% (65–69 years) to 5.0% (≥85 years) (p < 0.001). Only 58% (226/393) of participants with suspected AF attended the follow-up appointment (1–3 months after initial screen): mean CHA2DS2-VASc score 3.2 ± 1.2; 86.3% (195/226) had Class-1 oral anticoagulation recommendation, and 33% (75/226) had AF on 12-lead ECG. Conclusions: In Thailand, large-scale AF screening in the community is feasible using trained volunteer health workers, allowing screening of large numbers in a short time-period. Further investigation of this strategy is warranted, ensuring mechanisms to obtain a timely rhythm strip or 12-lead ECG locally, and a designated pathway to treatment. |
| first_indexed | 2024-12-19T06:44:20Z |
| format | Article |
| id | doaj.art-69be9bb5448242a69686aeb842e6c136 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-19T06:44:20Z |
| publishDate | 2021-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-69be9bb5448242a69686aeb842e6c1362022-12-21T20:31:58ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672021-02-0132100709Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre studyNijasri C. Suwanwela0Aurauma Chutinet1Hathairat Autjimanon2Tanawat Ounahachok3Chumpol Decha-umphai4Songkhram Chockchai5Saowanin Indrabhakti6Naruchorn Kijpaisalratana7Wasan Akarathanawat8Suporn Travanichakul9Teeraparp Kitjavijitre10Pakkawan Vongvasinkul11Ittaporn Kanacharoen12Tanyaluk O. Bunlikitkul13Supparat Charnwut14Nicole Lowres15Ben Freedman16Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Chulalongkorn Stroke Center, Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandDivision of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Corresponding author at: Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand 10330.King Narai Hospital, Lopburi, ThailandPanyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, ThailandPhrachomklao Hospital, Phetchaburi, ThailandFort Weerawatyothin Hospital, Surin, ThailandLerdsin Hospital, Bangkok, ThailandDivision of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandDivision of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandChulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandChulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandChulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandThe Medical Council of Thailand, Bangkok, ThailandChulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandChulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandHeart Research Institute, Sydney Australia; Faculty of Medicine and Health, University of Sydney, Sydney, AustraliaHeart Research Institute, Sydney Australia; Faculty of Medicine and Health, University of Sydney, Sydney, AustraliaBackground: In Thailand, almost one-quarter of strokes are related to atrial fibrillation (AF), and many could be prevented if AF were diagnosed and treated prior to the stroke. Therefore, we tested a novel strategy to screen large numbers of community residents using village health volunteers and primary care nurses. Methods: Local primary care nurses and village health volunteers in Phetchaburi and Lopburi provinces, Thailand were trained to perform AF screening using a blood pressure device with AF algorithm (Microlife A200 AFib). 10% of residents aged ≥ 65 years were randomly selected for screening during home-visits. Participants with possible AF were given follow-up appointments for further testing, including 12-lead ECG and echocardiogram. Results: Over two-months, 9.7% (13,864/143,478) of the target population were screened: mean age 73.2 ± 6.4 years, 32.4% male. The estimated AF prevalence (detected by Microlife A200 AFib) was 2.8% (95% CI, 2.6–3.1%) for age ≥ 65 years (i.e. 393/13,864 participants). Prevalence increased with age from 1.9% (65–69 years) to 5.0% (≥85 years) (p < 0.001). Only 58% (226/393) of participants with suspected AF attended the follow-up appointment (1–3 months after initial screen): mean CHA2DS2-VASc score 3.2 ± 1.2; 86.3% (195/226) had Class-1 oral anticoagulation recommendation, and 33% (75/226) had AF on 12-lead ECG. Conclusions: In Thailand, large-scale AF screening in the community is feasible using trained volunteer health workers, allowing screening of large numbers in a short time-period. Further investigation of this strategy is warranted, ensuring mechanisms to obtain a timely rhythm strip or 12-lead ECG locally, and a designated pathway to treatment.http://www.sciencedirect.com/science/article/pii/S2352906720304073Atrial fibrillationPrevalenceScreeningRisk factorsStroke risk |
| spellingShingle | Nijasri C. Suwanwela Aurauma Chutinet Hathairat Autjimanon Tanawat Ounahachok Chumpol Decha-umphai Songkhram Chockchai Saowanin Indrabhakti Naruchorn Kijpaisalratana Wasan Akarathanawat Suporn Travanichakul Teeraparp Kitjavijitre Pakkawan Vongvasinkul Ittaporn Kanacharoen Tanyaluk O. Bunlikitkul Supparat Charnwut Nicole Lowres Ben Freedman Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study International Journal of Cardiology: Heart & Vasculature Atrial fibrillation Prevalence Screening Risk factors Stroke risk |
| title | Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study |
| title_full | Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study |
| title_fullStr | Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study |
| title_full_unstemmed | Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study |
| title_short | Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study |
| title_sort | atrial fibrillation prevalence and risk profile from novel community based screening in thailand a prospective multi centre study |
| topic | Atrial fibrillation Prevalence Screening Risk factors Stroke risk |
| url | http://www.sciencedirect.com/science/article/pii/S2352906720304073 |
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