Strategies for heart disease in sub-Saharan Africa

Brink, A J; Aalbers, J

doi:10.1136/hrt.2009.175745

Cited by 12 publications

(9 citation statements)

References 5 publications

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“…Data from Leicester, United Kingdom is supportive of such findings [33]. Rheumatic heart disease though non existent within native European populations, is endemic in Sub-Saharan Africa and South East Asia [34]. With widespread immigration and travel from such areas, this may represent a significant aetiology within certain patient groups.…”

Section: Aetiologymentioning

confidence: 96%

Heart Failure Epidemiology: European Perspective

Guha¹,

McDonagh²

2013

CCR

119

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Heart failure poses an increasing problem for global healthcare systems. The epidemiological data which has been accrued over the last thirty years has predominantly been accumulated from experience within North America and Europe. Initial large cohort, prospective longitudinal studies produced the first publications; however latterly the focus has shifted onto epidemiological data governing hospitalisation and mortality. The emphasis behind this shift has been the resource implications with regards to repetitive, costly and prolonged hospitalisation. The European experience in heart failure, though similar to North America has recently demonstrated differences in hospitalisation which may underlie the differences between healthcare system configuration. Heart failure however remains an increasing global problem and the endpoint of a variety of cardiovascular diseases. Allied with the fact of increasingly elderly populations and prior data demonstrating a steep rise in prevalent cases within more elderly populations, it is likely that the increasing burden of disease will continue to pose challenges for modern healthcare. Despite the predicted increase in the number of patients affected by heart failure, over the last thirty years, a clear management algorithm has evolved for the use of pharmacotherapies (neuro-hormonal antagonists), device based therapies (Implantable Cardioverting Defibrillator (ICD) and Cardiac Resynchronisation Therapy (CRT)) and mechanical therapies including left ventricular assist devices and cardiac transplantation. Though the management of such patients has been clearly delineated in national and international guidelines, the underuse of all available and appropriate therapies remains a significant problem. When comparing various epidemiological studies from different settings and timepoints, it should be remembered that rates of prevalence and incidence may vary depending upon the definition used, methods of accumulating information (with the possibility of bias) and the chosen cut point of defining left ventricular systolic dysfunction (LVSD).

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Section: Aetiologymentioning

confidence: 96%

Heart Failure Epidemiology: European Perspective

Guha¹,

McDonagh²

2013

CCR

119

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“…Moreover, there are strong opinions that IHD in SSA affects mainly small Westernised populations and that it is a less serious cause of morbidity and mortality 2. Some of these authorities are of the opinion that cardiovascular risk factors in groups of older Africans, including obesity, diabetes and metabolic disorders are virtually non-existent and that IHD is bound to be a less serious threat, as there are very few black populations in the older age category 2…”

Section: Obstacles To Our Understanding Of Ihd In Ssamentioning

confidence: 99%

Epidemiology of ischaemic heart disease in sub-Saharan Africa : review article

Onen

2013

CVJA

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BackgroundThe epidemiology of ischaemic heart disease (IHD) in sub-Saharan Africa (SSA) remains largely enigmatic. Major obstacles to our understanding of the condition include lack of reliable health statistics, particularly cause-specific mortality data, inadequate diagnostic capabilities, shortage of physicians and cardiologists, and misguided opinions.MethodsThis review of the epidemiology of ischaemic heart disease in sub-Saharan Africa involved a systematic bibliographic MEDLINE search of published data on IHD in SSA over the past century. Search words included epidemiology, ischaemic (coronary) heart disease, myocardial infarction, cardiovascular risk factors and sub-Saharan Africa. Selected data are presented on the prevalence of cardiovascular risk factors and mortality from ischaemic heart disease from different countries representing the main regions of the continent.ResultsAlthough IHD in SSA remains relatively uncommon, its prevalence is predicted to rise in the next two decades due to the rising prevalence of risk factors, especially hypertension, diabetes, overweight and obesity, physical inactivity, increased tobacco use and dyslipidaemia. It is estimated that age-standardised mortality rates for IHD will rise by 27% in African men and 25% in women by 2015, and by 70 and 74%, respectively by 2030.ConclusionIschaemic heart disease remains relatively uncommon in SSA, despite an increasing prevalence of risk factors, but its incidence is rising. The pace and direction of economic development, rates of urbanisation, and changes in life expectancy resulting from the impact of pre-transitional diseases and violence will be major determinants of the IHD epidemic in SSA. The best window of opportunity for prevention of the emerging epidemic of ischaemic heart disease in sub-Saharan Africa is now.

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“…Although there is a paucity of data on heart diseases in sub-Saharan Africa, the consensus of experts is that rheumatic fever and the sequelae of rheumatic heart disease are the commonest forms of heart disease in Africa, followed closely by dilated cardiomyopathy 1-3. Both of these diseases affect mainly children and young adults from socio-economically disadvantaged segments of the population living in unsanitary conditions, which predisposes them to infectious diseases such as Group A Streptococcal pharyngitis, compounded by malnutrition as a consequence of poverty.…”

Section: Discussionmentioning

confidence: 99%

Cardiac surgical experience in northern Nigeria : cardiovascular topic

Nwiloh

Edaigbini

Danbauchi

et al. 2012

CVJA

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A pilot study was undertaken to determine the feasibility of establishing a heart surgery programme in northern Nigeria. During three medical missions by a visiting US team, in partnership with local physicians, 18 patients with heart diseases underwent surgery at two referral hospitals in the region. Sixteen (88.9%) patients underwent the planned operative procedure with an observed 30-day mortality of 12.5% (2/16) and 0% morbidity. Late complications were anticoagulant related in mechanical heart valve patients and included a first-trimester abortion one year postoperatively, and a death at two years from haemorrhage during pregnancy. This has prompted us to now consider bioprosthetics as the valve of choice in women of childbearing age in this patient population. This preliminary result has further stimulated the interest of all stakeholders on the urgency to establish open-heart surgery as part of the armamentarium to combat the ravages of heart diseases in northern Nigeria.

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Strategies for heart disease in sub-Saharan Africa

Cited by 12 publications

References 5 publications

Heart Failure Epidemiology: European Perspective

Heart Failure Epidemiology: European Perspective

Epidemiology of ischaemic heart disease in sub-Saharan Africa : review article

Cardiac surgical experience in northern Nigeria : cardiovascular topic

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