In Sri Lanka, atrial fibrillation was diagnosed predominantly in emergency (38%) or inpatient departments (26%) rather than primary care, with 97% receiving follow-up care and 39% experiencing negative COVID-19 impacts such as reduced healthcare visits and medication access.
Observational (n=151)
No
In Sri Lanka, AF is predominantly diagnosed in emergency or inpatient settings rather than primary care, highlighting a critical need to strengthen community-based early diagnosis and continuity of care.
Background Early diagnosis and continuity of care is vital for atrial fibrillation (AF), to reduce stroke ; There is a lack of understanding of when and how AF is being diagnosed and managed the care pathway) in in low- and middle-income countries (LMICs). We aimed to identify the AF care pathway in Northern Province, Sri Lanka and determine how the COVID-19 pandemic impacted the care pathway. Methods This descriptive longitudinal study utilised two quantitative questionnaires to evaluate the AF pathway: The first questionnaire (baseline) was used to identify where AF was being diagnosed and the second questionnaire (3 months following baseline) was used to identify where and how often AF follow-up care was being received. How the COVID-19 pandemic impacted the care pathway was asked in the second questionnaire. We aimed to recruit 236 adults (≥18 years) with AF from Jaffna Teaching Hospital. Data were collected between October 2020 and June 2021 and analysed using descriptive statistics. Results 151 participants were recruited (median age 57 years; 70% female). Most participants were diagnosed in the accident most visited an outpatient department (88%). The COVID-19 pandemic negatively impacted 39% of participants’ care: healthcare visits were reduced or, delayed or medications were unattainable, and longer intervals between blood tests were experienced; however, 24% of participants were able to receive their medication by ambulance, public health staff or post during lockdowns. Conclusions Primary care was not involved in the diagnosis of AF, indicating that most diagnoses occurr after a medical emergency. The frequency of blood tests was lower than the guideline recommendations of one per month which could in-part be due to the adverse impacts of the pandemic. Strengthening primary and community-based care may enable early diagnosis and improve continuity of care during and beyond future healthcare crises.
Sheron et al. (2026) conducted an observational in Atrial fibrillation (n=151). In Sri Lanka, atrial fibrillation was diagnosed predominantly in emergency (38%) or inpatient departments (26%) rather than primary care, with 97% receiving follow-up care and 39% experiencing negative COVID-19 impacts such as reduced healthcare visits and medication access.