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Buerger's disease in Nepal

K Fleshman1

  • 1Tansen Mission Hospital, Nepal. fleshman@open.org

Tropical Doctor
|November 6, 1998
PubMed

Insights

Thromboangiitis obliterans (Buerger's disease) amputations are 50 times more common in Nepal than North America. Extreme poverty, maize-heavy diets, and Himalayan residence are key co-factors alongside universal tobacco use.

Area of Science:

  • Vascular Surgery
  • Epidemiology
  • Public Health

Background:

  • Thromboangiitis obliterans (Buerger's disease) is a rare vascular condition.
  • Previous incidence data is primarily from Western countries.
  • High amputation rates suggest a significant, understudied regional burden.

Purpose of the Study:

  • To determine the incidence of Buerger's disease amputations in Nepal.
  • To investigate potential causative factors specific to the region.
  • To compare findings with international data.

Main Methods:

  • Retrospective analysis of 4-year discharge data from Tansen Mission Hospital.
  • In-depth interviews with patients regarding lifestyle, diet, genetics, and geography.
  • Calculation of incidence rates per 100,000 admissions.

Main Results:

  • An incidence of 693/100,000 admissions was recorded.
  • This represents an incidence approximately 50 times higher than in North America.
  • Consistent co-factors identified: 100% tobacco use, extreme poverty, maize-based diet, and Himalayan foothills residence.

Conclusions:

  • Nepal exhibits an exceptionally high incidence of Buerger's disease.
  • Tobacco use is universal, but poverty, diet, and geography are critical contributing factors.
  • Further research into these co-factors is crucial for targeted prevention strategies.

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