BMJ Open (Nov 2022)
Prevalence of atrial fibrillation in Northern Sri Lanka: a study protocol for a cross-sectional household survey
- ,
- Kate Jolly,
- Gregory Y H Lip,
- Krishnarajah Nirantharakumar,
- Hao Wang,
- Hui Zhang,
- Abi Beane,
- Rashan Haniffa,
- David Moore,
- Sheila Greenfield,
- Sue Jowett,
- Peter Brocklehurst,
- Isabela M Bensenor,
- Paulo A Lotufo,
- Semira Manaseki-Holland,
- Jingya Wang,
- Alessandra C Goulart,
- Trudie Lobban,
- Deirdre A Lane,
- Emma Lancashire,
- Kar Keung Cheng,
- Yutao Guo,
- Xuewen Li,
- Itamar S Santos,
- Mei Feng,
- Alena Shantsila,
- Graham Neil Thomas,
- Chamira Kodippily,
- Shribavan Kanesamoorthy,
- Vethanayagam Antony Sheron,
- Powsiga Uruthirakumar,
- Balachandran Kumarendran,
- Tiffany E Gooden,
- Mahesan Guruparan,
- Rajendra Surenthirakumaran,
- Kumaran Subaschandran,
- Ajini Arasalingam,
- Wahbi El-Bouri,
- Gustavo Gusso,
- Lindsey Humphreys,
- Yan-guang Li,
- Rodrigo D Olmos,
- Elisabete Paschoal,
- Paskaran Pirasanth,
- Carla Romagnolli,
- Isabelle Szmigin,
- Abi Meihui Tai,
- Timo Tolppa,
- Ana C Varella,
- Jiaoyue Zhong
Affiliations
- University of London, London, UK
- Kate Jolly
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- Gregory Y H Lip
- professor of cardiovascular medicine
- Krishnarajah Nirantharakumar
- Public Health, University of Birmingham, Birmingham, UK
- Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
- Hui Zhang
- 2 Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, China
- Abi Beane
- 2 Department of Critical care and Malaria, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Rashan Haniffa
- Centre for Inflammation Research, The University of Edinburgh, Edinburgh, UK
- David Moore
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Sue Jowett
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- Peter Brocklehurst
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, West Midlands, UK
- Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
- Paulo A Lotufo
- Department of Medicine, University of São Paulo, Sao Paulo, Brazil
- Semira Manaseki-Holland
- 1 Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Jingya Wang
- Aff1 grid.216938.70000000098787032State Key Laboratory of Medicinal Chemical Biology, College of Life SciencesNankai University Tianjin China
- Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
- Trudie Lobban
- Heart Arrhythmia Alliance, Chipping Norton, UK
- Deirdre A Lane
- lecturer in cardiovascular health
- Emma Lancashire
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, West Midlands, UK
- Yutao Guo
- 1 Department of Cardiology, Chinese PLA General Hospital, Beijing, China
- Xuewen Li
- 8 Department of Environment and Health, School of Public Health, Shandong University, Jinan, China
- Itamar S Santos
- 1 Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Mei Feng
- 1Evidence-based Medicine and Clinical research Service Group, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Alena Shantsila
- 3University of Birmingham,Institute of Cardiovascular Sciences,City Hospital
- Graham Neil Thomas
- 1University of Birmingham
- Chamira Kodippily
- National Intensive Care Surveillance-Mahidol Oxford Tropical Medicine Research Unit, Jaffna, Sri Lanka
- Shribavan Kanesamoorthy
- Department of Community and Family Medicine, University of Jaffna, Jaffna, Northern Province, Sri Lanka
- Vethanayagam Antony Sheron
- Department of Community and Family Medicine, University of Jaffna, Jaffna, Northern Province, Sri Lanka
- Powsiga Uruthirakumar
- Department of Community and Family Medicine, University of Jaffna, Jaffna, Northern Province, Sri Lanka
- Balachandran Kumarendran
- Department of Community and Family Medicine, University of Jaffna, Jaffna, Northern Province, Sri Lanka
- Tiffany E Gooden
- Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
- Mahesan Guruparan
- Department of Cardiology, Jaffna Teaching Hospital, Jaffna, Sri Lanka
- Rajendra Surenthirakumaran
- Department of Community and Family Medicine, University of Jaffna, Jaffna, Northern Province, Sri Lanka
- Kumaran Subaschandran
- Department of Community and Family Medicine, University of Jaffna, Jaffna, Northern Province, Sri Lanka
- Ajini Arasalingam
- Wahbi El-Bouri
- Gustavo Gusso
- Lindsey Humphreys
- Yan-guang Li
- Rodrigo D Olmos
- Elisabete Paschoal
- Paskaran Pirasanth
- Carla Romagnolli
- Isabelle Szmigin
- Abi Meihui Tai
- Timo Tolppa
- Ana C Varella
- Jiaoyue Zhong
- DOI
- https://doi.org/10.1136/bmjopen-2021-056480
- Journal volume & issue
-
Vol. 12,
no. 11
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.
