The Pandemic of Coronary Artery Disease in the Sub-Saharan Africa: What Clinicians Need to Know

Shehu, Muhammad N.; Adamu, Umar G.; Ojji, Dike B.; Ogah, Okechukwu S.; Sani, Mahmoud U.

doi:10.1007/s11883-023-01136-9

Cited by 4 publications

(5 citation statements)

References 40 publications

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“…The majority of patients with CAD had hypertension and a few of them had T2D, which are well known independent risk of developing CAD. However, hypertension showed a trend towards CAD risk, though it was not shown to be statistically significant contrary to other previous studies [ 4 , 11 ]. The reason for this observation remain elusive, however, a small sample size could have an impact on the power of the study.…”

Section: Discussioncontrasting

confidence: 99%

“…The prevalence of CAD was noted to have male gender preponderance and increasing with age consistent with studies conducted elsewhere, including analysis of global data by Khan MA et al [ 5 ], and in a review by Shehu, MN et al [ 11 ]. Age is a well-established independent risk factor for developing NCDs, CAD being not an exceptional.…”

Section: Discussionsupporting

confidence: 81%

“…T2D could operate through multiple mechanisms which include increased oxidative stress, endothelial injury, lipid peroxidation and ultimately atherosclerosis. Moreover, the co-existence of hypertension in the context of metabolic syndrome frequently exert synergistic effects to promote the development of CAD [ 11 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent review by Shehu, MN et al reports a steady increase in CAD prevalence and rising risk factors [ 11 ]. These traditional risk factors works continuously in an orchestrated manner over many years to promote the pathogenesis of atherosclerotic cardiovascular diseases (ASCVD) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Angiographic characteristics of coronary artery disease in patients undergoing diagnostic coronary angiography at a tertiary hospital in Tanzania

Meda,

Kusima,

Magitta

2024

BMC Cardiovasc Disord

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Background Coronary artery disease (CAD) is an important cause of global burden of disease. There is a paucity of data on the burden and risk factors for CAD in sub-Saharan Africa (SSA), despite the rising trends in the shared risk factors across regions. The recent introduction of cardiac catheterization laboratory services in SSA could shed light on the burden of CAD in the region. We aimed to assess the angiographic characteristics among patients undergoing diagnostic coronary angiography (CAG) at a single tertiary care hospital in Tanzania. Methods This study was a retrospective chart review. A total of 728 patients ≥ 18 years of age who underwent CAG from January 2020 to December 2022 were recruited into the study. Basic demographic variables, risk factors and clinical characteristics including CAG findings were obtained from the registry. In addition, CAG images were retrieved for assessment of angiographic features. The luminal vessel stenosis was assessed based on eyeballing and the degree of obstruction was agreed by two independent and experienced cardiologists. The coronary stenosis of ≥ 50% was considered significant for obstructive CAD. The study was approved by the local ethics committee. Results Of patients who were recruited into the study, 384 (52.23%) were female. The study participants had a mean age of 59.46 ± 10.83 standard deviation (SD) and mean body mass index (BMI) of 31.18 kg/m2. The prevalence of CAD of any degree was estimated at 24.43% (34.18% in male, 15.50% in female), while that of obstructive CAD was 18.27%. Forty six percent of those with obstructive CAD had multiple vessel disease (MVD). Nearly 77% of patients were found to have ≥ 50–70% luminal stenosis and while those with ≥ 70% luminal coronary artery stenosis constituted 56.65%. Right coronary artery (RCA) was the most commonly affected vessel, accounting for 36.84% when any vessel disease or 56% when single vessel disease were considered. Being 65 years or older and comorbidity with type 2 diabetes (T2D) were independent risk factors for developing CAD. Conclusion There is a high prevalence of obstructive CAD among patients undergoing diagnostic CAG in Tanzania, with male gender preponderance and increasingly higher in older age, often with severe disease. A large, prospective study is needed to provide epidemiological and clinical data for developing a locally-relevant cardio-preventive strategy for CAD intervention in Tanzania.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Angiographic characteristics of coronary artery disease in patients undergoing diagnostic coronary angiography at a tertiary hospital in Tanzania

Meda,

Kusima,

Magitta

2024

BMC Cardiovasc Disord

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“…Africa is experiencing an epidemiological transition following the considerable successes of global and national initiatives to improve the detection, prevention, and treatment of infectious diseases. Consequently, as the demographic of sub-Saharan Africa changes and non-communicable diseases become more common, cancer is becoming a leading cause of death (1)(2)(3)(4). This brings new challenges of detection and treatment, particularly for cancer treatment (5), with the diagnosis being one of the biggest gaps in the cancer care pathway (6)(7)(8), and, despite advances, there remain shortages of specific medical skills, limiting the potential of African health systems (9).…”

Section: Introductionmentioning

confidence: 99%

Development of an online teaching platform to improve access to postgraduate pathology training in sub-Saharan Africa

Byers,

Mumba

et al. 2024

Front. Med.

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BackgroundResource barriers to the provision of accessible training in cancer diagnosis in lower- and middle-income countries (LMICs) limit the potential of African health systems. Long-term provision via teaching visits from senior pathologists and trainee foreign placements is unsustainable due to the prohibitive costs of travel and subsistence. Emerging eLearning methods would allow pathologists to be trained by experts in a cheaper, more efficient, and more scalable way.PurposeThis study aimed to develop an online teaching platform, starting with hematopathology, for trainee pathologists in sub-Saharan Africa, initially in Nairobi, Kenya, and Lusaka, Zambia.MethodsCourse materials were prepared for both Canvas and the Zoom eLearning platforms using digitally scanned slides of lymph nodes and bone marrow trephines. Initial in-person visits were made to each site to establish trainee rapport and maximize engagement, evaluate different methods and course content, and obtain feedback to develop the project. The knowledge of trainees before and after course completion was used to measure initial effectiveness. Online teaching with the preferred platform is to be continued for 1 year before re-evaluation for long-term effectiveness.ResultsCanvas was selected as the preferred delivery platform as it is freely available and has good functionality to support all required tasks. Face-to-face teaching was considered optimal to establish the initial rapport necessary to maximize subsequent engagement with online teaching. Challenges have included sub-optimal internet speeds and connections and scheduling issues. Weekly online hematopathology teaching sessions using live image capture microscope sessions, Zoom, and Canvas have been delivered to students in Kenya and Zambia, with good attendance and interaction in case discussions.ConclusionOur team has successfully designed and delivered an online training program in hematopathology to trainee pathologists in Kenya and Zambia, which has been ongoing for over a year. This project is now being scaled to other sub-Saharan countries and other sub-specialties.

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Validity and Reproducibility of a Semiquantitative Food Frequency Questionnaire and Food Picture Book in Nigeria

Bigman,

Adebamowo,

Adebamowo

et al. 2024

Current Developments in Nutrition

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The Pandemic of Coronary Artery Disease in the Sub-Saharan Africa: What Clinicians Need to Know

Cited by 4 publications

References 40 publications

Angiographic characteristics of coronary artery disease in patients undergoing diagnostic coronary angiography at a tertiary hospital in Tanzania

Angiographic characteristics of coronary artery disease in patients undergoing diagnostic coronary angiography at a tertiary hospital in Tanzania

Development of an online teaching platform to improve access to postgraduate pathology training in sub-Saharan Africa

Validity and Reproducibility of a Semiquantitative Food Frequency Questionnaire and Food Picture Book in Nigeria

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