Screening for Atrial Fibrillation in Zambia’s Western Province
Bibliographic record
Abstract
BACKGROUND: The prevalence of atrial fibrillation (AF) is increasing in sub-Saharan Africa and contributes to significant morbidity and mortality from stroke and other cardiovascular diseases. Case finding in some areas of the country, such as in rural Zambia is especially challenging with limited availability of ambulatory electrocardiogram monitoring devices. Moreover, there is very little qualitative research exploring Zambian patients’ experiences living with AF. AIMS: The two-fold purpose of this study was i) to explore the use of a screening tool for detecting AF in Western Province, Zambia and ii) to understand the patient experience of living with AF. SETTING: Mongu and Limulunga Districts in the Western Province of Zambia. METHODS: Mixed methods. Convenience sampling for both quantitative and qualitative arms of the study was used to recruit participants attending public ‘Health Checks.’ Quantitative data were collected by means of an interview-administered survey and qualitative data were obtained through individual interviews. RESULTS: An irregular manual pulse was found in 12.6% (n=33) of Zambians who attended the Health Checks and two participants were confirmed to have AF. Zambians with an irregular pulse had a significantly higher prevalence of hypertension and were significantly less sedentary than those without pulse irregularities. Two themes emerged from the interview with two patients diagnosed with AF: symptoms and healthcare access. CONCLUSION: Hypertension continues to be a problem in adult Zambians and is an independent risk factor for stroke and, when diagnosed in conjunction with AF, further compounds stroke risk. Access to screening and diagnostic care for AF is essential, especially in currently underserved rural areas. In addition, participants presented with unique risk factors, such as consolidated periods of exercise, that require further research to determine context and seasonal variation so as to improve education and prevention strategies.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".