Lower Limb Vein Reflux Patterns and Clinical Correlates in Ghana

BACKGROUND: Peripheral venous disease is a major contributor of morbidity globally; however, limited data exist on its prevalence in sub-Saharan Africa. This study aims to describe the reflux patterns and clinical correlates of chronic venous disease in a Ghanaian population. METHODS: Patients who presented to Korle Bu Teaching Hospital between May 2021 and October 2024 were recruited prospectively into the study. All patients with suspected lower limb venous disease underwent a venous duplex scan by a qualified radiologist, with degree and location of incompetence, and diameter of veins recorded, alongside select patient and clinical factors. RESULTS: A total of 215 limbs from 147 patients were included in the study. The average age was 52.6 years and 72 (49.0%) were male. Venous insufficiency was most common in the great saphenous vein (GSV), occurring in 107 limbs (49.8%), with bilateral disease in 51 patients (34.7%). In addition, 89 limbs (41.4%) manifested clinical C0-C1 disease, 76 limbs (35.3%) had C2 disease, whereas 50 limbs (23.3%) had C3-C6 disease. The mean diameter of GSV was 7.4 mm at the saphenofemoral junction, 5.3 mm at the midthigh level, and 5.3 mm at the knee level. CONCLUSION: Around a quarter of patients in this study manifested late-stage disease, with the most common site of insufficiency being the GSV. There is a significant burden of venous disease in Ghana, and further work is required to develop structured vascular surgery services in the country.