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[NAIROBI] Two cardiovascular diseases — heart failure and stroke — account for 20 per cent of hospital admissions, with stroke rising 70-fold over 43 years, a study of a referral health facility in northern Tanzania has found.

An international team of researchers found the burden of heart failure and stroke on hospital admissions in the country to be “substantial”, with the volume of stroke admissions rising steeply.

“The burden of stroke admissions is increasing rapidly, and preventative interventions are needed to reduce the growing burden of cardiovascular disease among hospital admissions,” the study, published in the African Journal of Emergency Medicine this month (8 August), said.

“Lack of exercise contributes to hypertension. Sometimes, patients ignore signs such as chest pains or do not seek healthcare in good time.”

Blandina Mmbaga, Kilimanjaro Clinical Research Institute, Tanzania

Cardiovascular diseases, a group of disorders that affect the heart and blood vessels, cause about 45 per cent of the 41 million deaths resulting from noncommunicable or chronic diseases globally each year, with low- and middle-income countries affected most, the WHO says.

However, researchers say that despite the high burden of cardiovascular diseases in Sub-Saharan Africa, not enough is known about them, and policymakers are failing to adequately address the issue.

The study shows that of 291 adult patients admitted at the emergency department of the Kilimanjaro Christian Medical Centre for heart failure from 21 September 2017 to 22 March 2018, about 42 per cent of cases had uncontrolled hypertension, a major risk factor for heart attacks and strokes. The study identified 2,418 adult admissions over the study period.

Blandina Mmbaga, a co-author of the study and director of the Kilimanjaro Clinical Research Institute, Tanzania, explains: “Lack of exercise contributes to hypertension. Sometimes, patients ignore signs such as chest pains or do not seek healthcare in good time due to ignorance or [long] distance to hospital.

“Hypertension and heart failure can be reduced by lifestyle changes. There is a need for community surveillance, awareness creation and training of health centres to follow up on patients with hypertension.”

The study, which involved the analysis of medical records of patients who were at least 18 years old, included a comparative analysis of the trend and burden of stroke in the health facility since 1974.

“Adjusting for population growth, the annual volume of stroke admissions increased 70-fold in 43 years, from 2.9 admissions per 100,000 population in 1974 to 202.2 admissions per 100,000 in 2017,” the study says. Heart failure and stroke accounted for 12 per cent and eight per cent of the hospital admissions respectively over the study period.

Patients with cardiovascular diseases in Africa face a number of barriers to receiving the healthcare they need, including inequitable healthcare services which favour urban areas and high socio-economic households, according to a review of cardiovascular disease in Sub-Saharan Africa. Long journeys to health facilities, lack of affordability, and low health awareness were other factors cited. Fred Stephen Sarfo, a neurologist and senior lecturer at Kwame Nkrumah University of Science and Technology, Ghana, tells SciDev.Net that the findings of the study conducted in Tanzania are “relevant for policymakers” in Sub-Saharan Africa.

“A new paradigm is required to control the risk factors that lead to heart diseases and stroke which are leading causes of death in Africa," he adds.
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.


Julian T.Hertz and others The burden of acute coronary syndrome, heart failure, and stroke among emergency department admissions in Tanzania: A retrospective observational study (African Journal of Emergency Medicine, 8 August 2019)

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