Cardiovascular Disease in Africa
The prevalence of hypertension (HTN) in Sub-Saharan Africa is rising rapidly. Recent estimates from the World Health Organization (WHO) indicate that HTN is the leading cause of premature morbidity and mortality, and that prevention and control could prevent at least 250,000 deaths annually; however, estimates of awareness (40%), treatment (30%) and control (20%) are low. A clustering of risk factors with increased risk of CVD morbidity/mortality is also rising, leading to increased disease burden.
|Dr. Stuart-Shor, NP and cardiovascular specialist assessing a patient during the 2011 health screening and treatment.|
In April of 2010, a report released by the Institute of Medicine, titled “Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health” , reaffirmed the importance of the work we do in Kenya. The article notes, as we have in previous reports, that while the behaviors needed to reduce cardiovascular risk factors (eating healthy, being active, avoiding tobacco, and seeking regular health care) appear simple, understanding how to adapt this for a different continent is a far more complex job. In communities in both urban and rural Kenya, social and environmental factors prevent people from getting access to quality medical care, and lifestyles are drastically different. In addition, we have found that simply blaming the increase in cardiovascular/metabolic disease on increased westernization is overly simplistic. Clearly, this shows the need to develop a specifically Kenyan risk prediction model. These findings demonstrate that doctors and clinicians need to work within the communities themselves to develop effective, culturally-relevant programs to combat the rise of cardiovascular disease in Sub-Saharan Africa.
Data gathered over the years by Kenya Heart and Sole seems to suggest that standard risk factors for CVD/diabetes in the western world – sedentary lifestyle, smoking, and excessive consumption of soda and prepared foods – weren’t necessarily risk factors in Kenya. Populations that didn’t show these behaviors were nevertheless diagnosed with a greater-than-average rate of CV/metabolic diseases. More research must be done to understand what leads to these chronic conditions in Sub-Saharan Africa.
|UMass Boston NP master’s student, Monica, works with her Kenyan partner to treat a triaged client.|
The Institute of Medicine and World Health Organization has called on the world’s clinicians and researchers to exercise leadership and advocacy for chronic diseases, to build evidence-based and locally relevant solutions, to assess what works and disseminate innovation, to promote solutions through collaboration, and to work towards global progress. We have been working towards these goals for several years now. The purpose of Kenya Heart and Sole: The Afya Njema Project is to work in partnership with our Kenyan colleagues to improve cardiovascular health through the development of a feasible, sustainable, and culturally relevant CV/metabolic risk reduction program that emphasizes community engagement and self-management. Throughout the narrative of our trip, you will read about our work with our partners, the importance of collaboration, and the power of each individual to make a difference. Our work is focused on population health solutions, but populations are made up of individuals. The Kenyans we cared for were touched by what we did; our lives were transformed by what we saw. We returned enriched, energized and humbled by the journey.