Epidemiology of lower extremity artery disease in a rural setting in Benin, West Africa: The TAHES study

Background: Data on epidemiology of lower extremity artery disease (LEAD) in general population in Sub-Saharan Africa are sparse. This study aims to estimate the prevalence of LEAD among participants of Tanve Health Study (TAHES), a cohort about cardiovascular diseases (CVD) in a rural setting in Benin.

Methods: The cohort was launched since 2015 among adults aged over 25 years in Tanve, a village in Benin. Ankle-brachial index (ABI) was measured for the first time during the third annual visit of the cohort in 2017. Risk factors data were collected using the WHO STEPS adapted questionnaire in a systematic door-to-door survey. The LEAD was defined as ABI ≤ 0.90.

Results: We recorded ABI among 1003 out of 1407 TAHES' participants. A predominance of females (61.4%) was observed. The mean age was 44.4 ± 15.7 years and 49.9% were under 40 years. Regarding CVD risk factors, prevalences were estimated for sedentary behavior (68.2%), harmful use of alcohol (3.9%), fruit and vegetable low intake (96.0%), tobacco smoking (5.2%), Overweight or obesity (Body mass index > 25) (27.7%), raised blood pressure (36.8%) and raised blood glucose (5.4%). Prevalence of LEAD was 5.5% (95%CI: 4.2%–7.1%) in the sample, 7.0% (95%CI: 5.1%–9.4%) in women and 3.1% (95%CI: 1.7%–5.5%) in men. Five individuals (0.5%; 95%CI: 0.2%–1.2%) had incompressible arteries (ABI ≥ 1.40), including four men. In multivariate analysis, LEAD was significantly associated with age ≥ 55 years (OR: 2.17; 95%CI: 1.20–3.92; p = 0.009) and female gender (OR: 2.27; 95%CI: 1.17–4.40; p = 0.014).

Conclusion: Prevalence of LEAD is high in rural Benin and predominates among women and people over 55 years old.