High Rates of Atrial Fibrillation among Inpatients with Heart Failure or Ischemic Stroke in Southwestern Uganda
- 1Massachusetts General Hospital, Center for Global Health, Harvard Medical School, Boston, MA, USA
- 2Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- 3Mbarara Regional Referral Hospital, Mbarara, Uganda
Abstract
Background: Atrial fibrillation (AF) affects over 37 million people worldwide, and its prevalence is projected to increase by 60% by 2050. Addressing AF is critical in Uganda and elsewhere in sub-Saharan Africa, where data are lacking despite the high prevalence of AF risk factors, comorbidities, and sequelae.
Objectives: To evaluate AF prevalence among inpatients with acute heart failure or acute ischemic stroke in Uganda.
Methods: Between November 4, 2024 and November 30, 2025, we recruited a cohort of inpatients at the Regional Referral Hospital in Mbarara, Uganda with either acute heart failure or acute ischemic stroke. We collected baseline clinical data and hospital outcomes, performed a transthoracic echocardiogram, and equipped participants with a 24-hour Holter monitor. A multivariable logistic regression model was fitted for a primary outcome of AF detection.
Results: Among 250 individuals, mean age was 61.7 years (SD 20.5), of whom 175 (70.0%) were women. 123 (49.2%) had acute heart failure; 127 (50.8%) had acute ischemic stroke. Holter monitors detected AF in 105 (42.0%), with a mean AF duration of 11.0 hours (IQR 1.0–21.9) with a bimodal distribution. Mean stroke risk (CHA2DS2VA) was 3.5 (SD 1.6). Factors associated with AF included increasing age in years (OR 1.04, 95% CI 1.02–1.06) and left atrial volume index (mL/m2) (OR 1.02, 95% CI 1.01–1.03).
Conclusions: We found high rates of AF among inpatients with acute heart failure or acute ischemic stroke, comparable to studies from the United States and Europe. These findings highlight the need to address AF in Uganda, with improved screening using long-term monitors, updated treatment protocols, and broadened access to cardiac care.
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BibTeX
@article{olds2026high,
title = {{High Rates of Atrial Fibrillation among Inpatients with Heart Failure or Ischemic Stroke in Southwestern Uganda}},
author = {Peter K. Olds and Precious Twesigye and Lydia Nakawesa and Ivan Kasomba and Jessica E. Haberer and Abeya Fardous},
journal = {Annals of global health},
year = {2026},
month = oct,
doi = {10.5334/aogh.5389},
url = {https://europepmc.org/article/PMC/PMC13722017},
note = {CC BY},
}
RIS
TY - JOUR
TI - High Rates of Atrial Fibrillation among Inpatients with Heart Failure or Ischemic Stroke in Southwestern Uganda
AU - Peter K. Olds
AU - Precious Twesigye
AU - Lydia Nakawesa
AU - Ivan Kasomba
AU - Jessica E. Haberer
AU - Abeya Fardous
PY - 2026
DA - 2026/10/29
JO - Annals of global health
DO - 10.5334/aogh.5389
UR - https://europepmc.org/article/PMC/PMC13722017
AB - Background: Atrial fibrillation (AF) affects over 37 million people worldwide, and its prevalence is projected to increase by 60% by 2050. Addressing AF is critical in Uganda and elsewhere in sub-Saharan Africa, where data are lacking despite the high prevalence of AF risk factors, comorbidities, and sequelae. Objectives: To evaluate AF prevalence among inpatients with acute heart failure or acute ischemic stroke in Uganda. Methods: Between November 4, 2024 and November 30, 2025, we recruited a cohort of inpatients at the Regional Referral Hospital in Mbarara, Uganda with either acute heart failure or acute ischemic stroke. We collected baseline clinical data and hospital outcomes, performed a transthoracic echocardiogram, and equipped participants with a 24-hour Holter monitor. A multivariable logistic regression model was fitted for a primary outcome of AF detection. Results: Among 250 individuals, mean age was 61.7 years (SD 20.5), of whom 175 (70.0%) were women. 123 (49.2%) had acute heart failure; 127 (50.8%) had acute ischemic stroke. Holter monitors detected AF in 105 (42.0%), with a mean AF duration of 11.0 hours (IQR 1.0–21.9) with a bimodal distribution. Mean stroke risk (CHA2DS2VA) was 3.5 (SD 1.6). Factors associated with AF included increasing age in years (OR 1.04, 95% CI 1.02–1.06) and left atrial volume index (mL/m2) (OR 1.02, 95% CI 1.01–1.03). Conclusions: We found high rates of AF among inpatients with acute heart failure or acute ischemic stroke, comparable to studies from the United States and Europe. These findings highlight the need to address AF in Uganda, with improved screening using long-term monitors, updated treatment protocols, and broadened access to cardiac care.
SN - 2214-9996
ER -