scholarly journals Heart Failure in Sub-Saharan Africa

2018 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Joseph Gallagher ◽  
Kenneth McDonald ◽  
Mark Ledwidge ◽  
Chris J Watson ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Sub Saharan Africa ◽  
Essential Medicines ◽  
Endomyocardial Fibrosis ◽  
Technical Expertise ◽  
Significant Issue ◽  
Access To Essential Medicines ◽  
Sub Saharan ◽  
Rheumatic Heart

Heart failure is a growing problem in sub-Saharan Africa. This arises as the prevalence of risk factors for cardiovascular disease rises, life expectancy increases and causes of heart failure more common in Africa, such as rheumatic heart disease and endomyocardial fibrosis, continue to be a significant issue. Lack of access to diagnostics is an issue with the expense and technical expertise required for echocardiography limiting access. Biomarker strategies may play a role here. Access to essential medicines is also limited and requires a renewed focus by the international community to ensure that appropriate medications are readily available, similar to that which has been implemented for HIV and malaria.

scholarly journals Risk factors and prevalence of dilated cardiomyopathy in Sub Sahara Africa: a systematic review article (Preprint)

2020 ◽  
Author(s):  
Linda Van Laake ◽  
Lulu Said Fundikira ◽  
Pilly Chillo ◽  
David G Paulo ◽  
Reuben Kato Mutagaywa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Preventive Measures ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Sub Saharan Africa ◽  
Inclusion Criteria ◽  
Reference Manager ◽  
Sub Saharan

BACKGROUND Cardiomyopathies, defined as diseases involving mainly the heart muscle, are linked to 5.9 of 100,000 of estimated mortality of the global population although underdiagnosis is significant. In sub Saharan Africa, studies show that cardiomyopathy constitutes 21.4% of cases with heart failure and comes second only to hypertensive heart disease. However, there is paucity of data in the region regarding the different types of cardiomyopathies. It has been noted that presence of non-modifiable cardiovascular risk factors such as family history, age, ethnicity, gender as well as modifiable risk factors such as hypertension, diabetes, tobacco use, physical inactivity, poor nutrition, excessive alcohol consumption, high cholesterol and obesity increase the probability of developing cardiovascular disease. OBJECTIVE The review will focus on available literature in sub- Saharan Africa on prevalence of dilated cardiomyopathy (DCM) and associated risk factors in patients with DCM. It will identify gaps in knowledge regarding DCM and establish a foundation for preventive measures through reduction of the risk factors. This will be the first review that focuses solely on DCM while updating available data from previous reviews on cardiomyopathies in sub Saharan Africa. METHODS The review will consider all studies, qualitative and quantitative, which involve patients with a diagnosis of dilated cardiomyopathy as well as risk factors encountered in such patients in sub Saharan Africa. Both hospital based and community based studies will be included. Indexed articles in Medline and Embase will be searched. Full copies of articles identified by the search, and considered to meet the inclusion criteria, based on their title, abstract and subject descriptors, will be obtained for data synthesis. Bibliographic searches will also be considered for data collection based on their titles. The collected data will be organized in Mendeley reference manager and later on uploaded to Rayyan web application for systematic reviews articles to allow adequate sorting. Two reviewers will independently select articles against the inclusion criteria. Discrepancies in reviewer selections will be resolved by a third author (arbitrator) prior to selected articles being retrieved. RESULTS Interventions to be documented will include those related to screening and control of risk factors that may lead to DCM, and presence of assessment strategies in patients suspected with DCM. The primary outcome will be the number of cases with different etiologies of DCM. Secondary outcomes will be the number of hospitalizations, mortality due to heart failure, incidence of sudden cardiac death, proportion of participants on heart failure medications, proportion of participants with implantable cardioverter defibrillator placements, number of cases with left ventricular assist device and number of heart transplants in patients with DCM. CONCLUSIONS The review will give an update on the status of DCM in sub Sahara Africa and identify gaps that need to be addressed in order to improve preventive measures as well as management of this condition.

scholarly journals Rarity of Heart Failure in a Traditional African Population. A Rural Community Based Study

2016 ◽  
Vol 8 ◽  
Author(s):  
Basil Nwaneri Okeahialam ◽  
Hadiza Abigail Agbo ◽  
Chikaike Ogbonna ◽  
Evelyn Chuhwak ◽  
Ikechukwu Isiguzoro
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Secondary Analysis ◽  
The Elderly ◽  
Sub Saharan Africa ◽  
Rural Nigeria ◽  
African Community ◽  
Sub Saharan

<p>BACKGROUND: Heart failure (HF) is common globally and increases with age. Among Caucasians it affects mainly the elderly, but the middle-aged in Africa. Statistics are usually hospital based, missing those in the population unable to present in hospital for various reasons. Population statistics of HF for sub-Saharan Africa are hardly available. This was to assess the population prevalence of HF in a rural sub-Sahara African community and get a truer picture of HF morbidity.</p><p>METHODS: Secondary analysis of data from a population study of cardiovascular disease risk factors in rural Nigeria; on self-reported HF as part of general history, physical examination and related laboratory investigations</p><p> RESULTS: Of the 840 subjects, 231 were men; 8 (0.95%) of whom were in HF (2M, 6F); and aged between 50 to 90 years. All the men were above 65 years while 2 of the women were less than 65 years. Four were hypertensive, 3 had hypertension and diabetes; while 1 the oldest had neither. They all denied tobacco and alcohol use. Most of the affected women were multiparous.</p><p>CONCLUSION: HF is infrequent in rural Nigeria with a prevalence of 0.95%. Hypertension was a prominent risk factor, with co-morbid diabetes. The absence of tobacco /alcohol history, anaemia and low rate of kidney disease confirms that a constellation of risk factors is required for HF among hypertensives. The earlier presentation and greater involvement of women (in the background of multiparity) supports the notion that repeated pregnancy and child-birth place higher disease burden of hearts of women.</p>

Cardiovascular risk factors and disease among non-European immigrants living in Catalonia

Heart ◽  
2019 ◽  
pp. heartjnl-2018-314436
Author(s):  
Miguel Cainzos-Achirica ◽  
Emili Vela ◽  
Montse Cleries ◽  
Usama Bilal ◽  
Josepa Mauri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Universal Access ◽  
South Asians ◽  
Local Population ◽  
Sub Saharan Africa ◽  
Cvd Risk ◽  
Sub Saharan

ObjectiveTo describe the prevalence and incidence of cardiovascular risk factors, established cardiovascular disease (CVD) and cardiovascular medication use, among immigrant individuals of diverse national origins living in Catalonia (Spain), a region receiving large groups of immigrants from all around the world, and with universal access to healthcare.MethodsWe conducted a population-based analysis including >6 million adult individuals living in Catalonia, using the local administrative healthcare databases. Immigrants were classified in 6 World Bank geographic areas: Latin America/Caribbean, North Africa/Middle East, sub-Saharan Africa, East Asia and South Asia. Prevalence calculations were set as of 31 December 2017.ResultsImmigrant groups were younger than the local population; despite this, the prevalence of CVD risk factors and of established CVD was very high in some immigrant subgroups compared with local individuals. South Asians had the highest prevalence of diabetes, and of hyperlipidemia among adults aged <55 years; hypertension was highly prevalent among sub-Saharan Africans, and obesity was most common among women of African and South Asian ancestry. In this context, South Asians had the highest prevalence of coronary heart disease across all groups, and of heart failure among women. Heart failure was also highly prevalent in African women.ConclusionsThe high prevalence of risk factors and established CVD among South Asians and sub-Saharan Africans stresses the need for tailored, aggressive health promotion interventions. These are likely to be beneficial in Catalonia, and in countries receiving similar migratory fluxes, as well as in their countries of origin.

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

scholarly journals Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039456
Author(s):  
Leolin Katsidzira ◽  
Wisdom F Mudombi ◽  
Rudo Makunike-Mutasa ◽  
Bahtiyar Yilmaz ◽  
Annika Blank ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Case Control Study ◽  
Alpha Diversity ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Inflammatory Bowel ◽  
Sub Saharan ◽  
Nested Case Control ◽  
Control Study

IntroductionThe epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysisA prospective observational registry with a nested case–control study has been established at a tertiary hospital in Harare, Zimbabwe. The registry is recruiting confirmed IBD cases from the hospital, and other facilities throughout Zimbabwe. Demographic and clinical data are obtained at baseline, 6 months and annually. Two age and sex-matched non-IBD controls per case are recruited—a sibling or second-degree relative, and a randomly selected individual from the same neighbourhood. Cases and controls are interviewed for potential risk factors of IBD, and dietary intake using a food frequency questionnaire. Stool is collected for 16S rRNA-based microbiota profiling, and along with germline DNA from peripheral blood, is being biobanked. The estimated sample size is 86 cases and 172 controls, and the overall registry is anticipated to run for at least 5 years. Descriptive statistics will be used to describe the demographic and phenotypic characteristics of IBD, and incidence and prevalence will be estimated for Harare. Risk factors for IBD will be analysed using conditional logistic regression. For microbial analysis, alpha diversity and beta diversity will be compared between cases and controls, and between IBD phenotypes. Mann-Whitney U tests for alpha diversity and Adonis (Permutational Multivariate Analysis of Variance) for beta diversity will be computed.Ethics and disseminationEthical approval has been obtained from the Parirenyatwa Hospital’s and University of Zimbabwe’s research ethics committee and the Medical Research Council of Zimbabwe. Findings will be discussed with patients, and the Zimbabwean Ministry of Health. Results will be presented at scientific meetings, published in peer reviewed journals, and on social media.Trial registration numberNCT04178408.

scholarly journals Estimating the burden of cardiovascular risk in community dwellers over 40 years old in South Africa, Kenya, Burkina Faso and Ghana

2021 ◽  
Vol 6 (1) ◽  
pp. e003499
Author(s):  
Ryan G Wagner ◽  
Nigel J Crowther ◽  
Lisa K Micklesfield ◽  
Palwende Romauld Boua ◽  
Engelbert A Nonterah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
South African ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Cvd Risk ◽  
Genomic Studies ◽  
Sub Saharan ◽  
Context Specific ◽  
The Impact

IntroductionCardiovascular disease (CVD) risk factors are increasing in sub-Saharan Africa. The impact of these risk factors on future CVD outcomes and burden is poorly understood. We examined the magnitude of modifiable risk factors, estimated future CVD risk and compared results between three commonly used 10-year CVD risk factor algorithms and their variants in four African countries.MethodsIn the Africa-Wits-INDEPTH partnership for Genomic studies (the AWI-Gen Study), 10 349 randomly sampled individuals aged 40–60 years from six sites participated in a survey, with blood pressure, blood glucose and lipid levels measured. Using these data, 10-year CVD risk estimates using Framingham, Globorisk and WHO-CVD and their office-based variants were generated. Differences in future CVD risk and results by algorithm are described using kappa and coefficients to examine agreement and correlations, respectively.ResultsThe 10-year CVD risk across all participants in all sites varied from 2.6% (95% CI: 1.6% to 4.1%) using the WHO-CVD lab algorithm to 6.5% (95% CI: 3.7% to 11.4%) using the Framingham office algorithm, with substantial differences in risk between sites. The highest risk was in South African settings (in urban Soweto: 8.9% (IQR: 5.3–15.3)). Agreement between algorithms was low to moderate (kappa from 0.03 to 0.55) and correlations ranged between 0.28 and 0.70. Depending on the algorithm used, those at high risk (defined as risk of 10-year CVD event >20%) who were under treatment for a modifiable risk factor ranged from 19.2% to 33.9%, with substantial variation by both sex and site.ConclusionThe African sites in this study are at different stages of an ongoing epidemiological transition as evidenced by both risk factor levels and estimated 10-year CVD risk. There is low correlation and disparate levels of population risk, predicted by different risk algorithms, within sites. Validating existing risk algorithms or designing context-specific 10-year CVD risk algorithms is essential for accurately defining population risk and targeting national policies and individual CVD treatment on the African continent.

scholarly journals Contrasting Monetary and Multidimensional Poverty Measures in a Low-Income Sub-Saharan African Country

2020 ◽  
Vol 151 (2) ◽  
pp. 547-574 ◽  
Author(s):  
Lukas Salecker ◽  
Anar K. Ahmadov ◽  
Leyla Karimli
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Multidimensional Poverty ◽  
Poverty Measurement ◽  
Sub Saharan Africa ◽  
Analytical Strategy ◽  
Poverty Risk ◽  
Two Measures ◽  
Sub Saharan ◽  
Over Time

AbstractDespite significant progress in poverty measurement, few studies have undertaken an in-depth comparison of monetary and multidimensional measures in the context of low-income countries and fewer still in Sub-Saharan Africa. Yet the differences can be particularly consequential in these settings. We address this gap by applying a distinct analytical strategy to the case of Rwanda. Using data from two waves of the Rwandan Integrated Household Living Conditions Survey, we combine comparing poverty rates cross-sectionally and over time, examining the overlaps and differences in the two measures, investigating poverty rates within population sub-groups, and estimating several statistical models to assess the differences between the two measures in identifying poverty risk factors. We find that using a monetary measure alone does not capture high incidence of multidimensional poverty in both waves, that it is possible to be multidimensional poor without being monetary poor, and that using a monetary measure alone overlooks significant change in multidimensional poverty over time. The two measures also differ in which poverty risk factors they put emphasis on. Relying only on monetary measures in low-income sub-Saharan Africa can send inaccurate signals to policymakers regarding the optimal design of social policies as well as monitoring their effectiveness.

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