PLOS ONE | www.plosone.org
September 2014 | Volume 9 | Issue 9 | e103657
Summary Report on the Comprehensive Study
This study is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of their authors and do not necessarily reflect the views of USAID or th...e United States Government.
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F1000Research 2019, 8:323 Last updated: 17 MAY 2019
Kan M et al. Journal of the International AIDS Society 2018, 21(S5):e25139 http://onlinelibrary.wiley.com/doi/10.1002/jia2.25139/full | https://doi.org/10.1002/jia2.25139
Tokar A, et al. Sex Transm Infect 2019;95:193–200. doi:10.1136/sextrans-2018-053684
Tokar et al. Health Research Policy and Systems (2019) 17:23 https://doi.org/10.1186/s12961-019-0415-4
Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t...hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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