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After years of relative calm, Zimbabwe has been grappling with a cholera outbreak since 12 February 2023. This resurgence is not an isolated incident, as 10 more countries (Malawi, Mozambique, Somalia, Kenya, Ethiopia, Zambia, South Sudan, Burundi, Tanzania and South Africa) in Eastern and Southern
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Africa are facing similar challenges with cholera an acute watery diarrhea.
To date, a total of 13,176 suspected cases and 1,543 confirmed cases have been reported.This stark reality underscores the need for continued coordinated action to control the spread of this preventable disease.
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Worldwide, there are about 17 million deaths due to cardiovascular disease (CVD) each year and at least two or three times as many non-fatal events. Raised cholesterol greatly increases the risks of stroke and heart disease, causing a large
health burden across the world. The World Health Organizat
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ion has identified control of cholesterol as part of a Total Risk Approach to the prevention of CVD as a public health priority.
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Background: Worldwide, maternal hypertensive disorders complicate one in ten pregnancies. As a result of changes in the life styles of society, currently, it is becoming a common public life encounter. However, Ethiopia lacks comprehensive and comparable maternal hypertensive disorders, causing burd
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en and health loss to inform policy and practice.
Objective: To describe the incidence and prevalence of maternal hypertensive disorders and deaths, Disability Adjusted Life Years, and Years Life Lost attributable to maternal hypertensive disorders in Ethiopia and its regional distributions from 1990 to 2019 as part of a collaborative Global Burden of Diseases, (2019) Study.
Methods: The data for this study were collected from surveys, demographic surveillances, medical record reviews, health facility observations and interviews socio-demographic, health care service utilization, and other data sources such as case notifications, scientific literature, and unpublished data as per the Global Burden of Disease protocol and analysis techniques to produce national and regional estimates of maternal hypertensive disorders in Ethiopia. Cause of death ensemble modeling and Bayesian meta-regression disease modeling was employed to ascertain cause of death and morbidity. Each metric was estimated per 100,000 populations with a 95% uncertainty interval (UI).
Results: In the last thirty years, in Ethiopia, , the incidence of maternal hypertensive disorders among young women was raised by 52,596 cases per 100,000 population [199,707 (95% UI 150,261-267,221) to 252,303 (95% UI 191,335-332,524)], while decreased among adolescent women from 67,206 (95% UI 46,887-90,883) to 64, 622 (95% UI; 47,587-84,664) per 100,000 population. The prevalence among women of reproductive age had increased from 94, 818 (95% UI 59,434-135,332) in 1990 to 138, 263 (95% UI 88,447-196,029) in 2019. Between 1990 and 2019, deaths attributable to maternal hypertensive disorders among adolescents and young women had increased by 1.5 and 1.17 times, respectively. In 2019, disability adjusted life years among adolescent, young women and women of reproductive age due to maternal hypertensive disorders was 8,493 (UI 95% 5,370-12,849), 21,812 (UI 95% 14,682-32,139) and 57,867 (UI 95% 41,751-79,165) respectively. The highest daily adjusted life years due to maternal hypertensive disorders had occurred among young women, 13,319 (UI 95% 8,592-19,931) which was higher than 1990 whereas the young women years of life lost had increased.
Conclusions: Based on the finding, increasingly high new cases, prevalence and burden of maternal hypertensive disorders and significant health loss were observed in the last three decades in Ethiopia. Hence, prevention of cases, disabilities, deaths and health losses caused by maternal hypertensive disorders can be prevented by properly advocating lifestyle modifications with specifically designed age-specific interventions. On the top of continuing prevention efforts with newly devised magnesium sulphate administration in the new ANC initiative of the ministry, contextualized, need based, localized, and targeted interventions could be reconstituted. [Ethiop. J. Health Dev. 2023;37 (SI-2)]
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Africa is experiencing an increasing burden of cardiac arrhythmias. Unfortunately, the expanding need for appropriate care remains largely unmet because of inadequate funding, shortage of essential medical expertise, and the high cost of diagnostic equipment and treatment modalities. Thus, patients
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receive suboptimal care. A total of 5 of 34 countries (15%) in Sub-Saharan Africa (SSA) lack a single trained cardiologist to provide basic cardiac care. One-third of the SSA countries do not have a single pacemaker center, and more than one-half do not have a coronary catheterization laboratory. Only South Africa and several North African countries provide complete services for cardiac arrhythmias, leaving more than hundreds of millions of people in SSA without access to arrhythmia care considered standard in other parts of the world. Key strategies to improve arrhythmia care in Africa include greater government health care funding, increased emphasis on personnel training through fellowship programs, and greater focus on preventive care.
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Polio Bulletin
2024 Issue No. 1 - Week 1 (as of 2 January 2024)
Sodium Benchmarks for Packaged Foods
Neglected tropical diseases (NTDs) are a category of chronic, disabling, and at times disfiguring diseases and conditions that occur most commonly in the setting of extreme poverty. Historically, NTDs have received less attention and funding when compared to other diseases occurring in the same regi
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ons of the world. Several NTDs have internationally agreed upon targets for their control, elimination, and eradication. Nineteen countries in the WHO African Region have successfully eliminated at least one NTD, however recent gap analyses identified moderate to severe gaps across technical, strategy and service delivery, and enabling factors. This report summarizes the findings of a scoping review of published literature undertaken to highlight control, elimination, and eradication efforts towards NTDs across the WHO African Region over the last 30 years.
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This publication describes the history of malaria in Uzbekistan. It evaluates the policies and strategies applied after the re-establishment of local transmission to contain malaria outbreaks in the 1990s and early 2000s, and highlights the interventions subsequently used to eliminate malaria in the
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country. Uzbekistan was officially certified by WHO as a malaria-free country in 2018. Lessons for countries embarking upon elimination are distilled. The publication is intended for health managers and personnel, researchers, teachers, students and post-graduates at medical schools.
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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
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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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Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burden in this already highly affected and resource-lim
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ited continent
Methods: This was a cross-sectional e-survey study conducted amongst cardiologists in African countries. The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction.
Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02).
Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.
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How to Improve Awareness, Treatment, and Control of Hypertension in Africa, and How to Reduce Its Consequences: A Call to Action From the World Hypertension League
Parati, G.; Lackland, G.T.; Campbell, N.R.C. et al.
Hypertension Volume 79, Issue 9, September 2022; Pages 1949-1961
(2022)
CC
Hypertension is the leading preventable risk factor for cardiovascular diseases and disability globally. In low- and middle-income countries hypertension has a major social impact, increasing the disease burden and costs for national health systems. The present call to action aims to stimulate all A
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frican countries to adopt several solutions to achieve better hypertension management. The following 3 goals should be achieved in Africa by 2030: (1) 80% of adults with high blood pressure in Africa are diagnosed; (2) 80% of diagnosed hypertensives, that is, 64% of all hypertensives, are treated; and (3) 80% of treated hypertensive patients are controlled. To achieve these aims, we call on individuals and organizations from government, private sector, health care, and civil society in Africa and indeed on all Africans to undertake a few specific high priority actions. The aim is to improve the detection, diagnosis, management, and control of hypertension, now considered to be the leading preventable killer in Africa.
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The situation in the Gaza Strip is dire, with syndromic surveillance revealing high rates of infectious diseases. The risk of further spread may be exacerbated by several factors, including overcrowding, inadequate water and sanitation, disruption of routine healthcare services, and a dysfunctional
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health system due to the ongoing conflict.
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The region of Latin America and the Caribbean (LAC) has high levels of income inequality and urbanization. This leaves a large percentage of the population exposed and vulnerable to infectious disease outbreaks (1). The COVID-19 outbreak occurred suddenly, within a complex economic, social and polit
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ical context and at a time of low economic growth and high levels of informal labour. Structural challenges of poverty, deep inequality across different dimensions, and weak health and social protection systems exacerbated the region’s vulnerability to the pandemic
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En 2023, la nouvelle stratégie de Coopération de l’OMS avec le Niger 2023-2027 a été lancée, assortie d’un plan d’investissement. En outre, l’OMS a soutenu plusieurs initiatives majeures du pays, comme le lancement effectif de la Stratégie nationale de la Couverture Sanitaire Universel
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le (CSU) 2023-2030, la mise à jour de la Stratégie nationale de financement de la santé, la mise en œuvre de la stratégie Triage, Évaluation et Traitement des Urgences pédiatriques (TETU) dans plusieurs régions. De nombreuses actions ont aussi été menées dans d’autres domaines, comme la riposte apportée à l’épidémie de diphtérie, le soutien continu à la vaccination de routine, l’appui au maintien de la chaine du froid pour les vaccins (menacée par l’interruption de la fourniture d’énergie), etc.
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When explosive weapons are used in populated areas, they have direct and indirect impacts
on the provision of services, community cohesion, humanitarian access, regular support for
basic needs, physical safety, mental health and psychological well-being, as well as other
social and economic impac
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ts. The challenges and human impacts in hard-to-reach areas –
such as in Kharkiv, Mykolaiv and Kherson Oblasts – exemplify the specific and systematic
pattern of harm caused by explosive weapons during and after armed conflicts.
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This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure and function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards
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have now been reduced to six but without sacrificing any of the key elements and with a greater emphasis placed on measurable clinical outcomes, audit and certification. Similarly, the second edition provided an overview of seven core components felt to be essential for the delivery of quality prevention and rehabilitation, and this too has been reduced to six. The interplay between cardio-protective therapies and medical risk factors is almost impossible to disentangle for the vast majority of patients and even if specific drug therapies are deployed exclusively for risk factor modulation, the indirect effect will also be cardio-protective. Thus, these have been combined into a single core component – medical risk management.
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The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital
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heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.
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Position statement for adult and paediatric spirometry in South Africa: 2022 update
Maree, D.M.; Swanepoel, R.A.; Swart, F. et al.
African Journal of Thoracic and Critical Care Medicine
(2022)
CC
Spirometry is required as part of the comprehensive evaluation of both adult and paediatric individuals with suspected or confirmed respiratory diseases and occupational assessments. It is used in the categorisation of impairment, grading of severity, assessment of potential progression and response
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to interventions. Guidelines for spirometry in South Africa are required to improve the quality, standardisation and usefulness in local respiratory practice. The broad principles of spirometry have remained largely unchanged from previous versions of the South African Spirometry Guidelines; however, minor adjustments have been incorporated from more comprehensive international guidelines, including adoption of the Global Lung Function Initiative 2012 (GLI 2012) spirometry reference equations for the South African population.
All equipment should have proof of validation regarding resolution and consistency of the system. Daily calibration must be performed, and equipment quality control processes adhered to. It is important to have standard operating procedures to ensure consistency and quality and, additionally, strict infection control as highlighted during the COVID-19 pandemic.
Adequate spirometry relies on a competent, trained operator, accurate equipment, standardised operating procedures, quality control and patient co-operation. All manoeuvres must be performed strictly according to guidelines, and strict quality assurance methods should be in place, including acceptability criteria (for any given effort) and repeatability (between efforts).
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The document systematically examines dietary and lifestyle factors influencing non-communicable diseases (NCDs) in the Western Pacific region. It highlights regional nutrition transitions, including dietary improvements like increased fruit and vegetable consumption and reduced salt intake, alongsid
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e challenges like rising ultra-processed food consumption. The findings stress the need for stronger national policies, tailored interventions, and international collaboration to reduce NCD risks and improve public health outcomes.
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The article explores the underlying factors influencing unhealthy diets and sedentary lifestyles among adolescents in Kilifi County, Kenya. Using a qualitative approach, the study involved interviews and focus group discussions with adolescents, stakeholders, and young adults. Key findings include a
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preference for unhealthy, carbohydrate-rich, and sugary foods over traditional and nutritious options, exacerbated by factors like low socioeconomic status, urbanization, and poor farming practices.
Sedentary behavior, such as gambling and extensive technology use, was prevalent, often replacing physical activity. Protective factors like school attendance, community-based services, and parental engagement were identified as mitigating risks. The study highlights the importance of ecological intervention strategies targeting intrapersonal, interpersonal, and community factors to address unhealthy behaviors and promote better health outcomes in adolescents.
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