The state of heart disease in Sudan : review article

Abstract

Cardiovascular disease (CVD) is the leading cause of mortality worldwide and an important cause of disability. In Africa, the burden of CVD is increasing rapidly and it is now a public health concern. Epidemiological data on diseases is scarce and fragmented on the continent.AimTo review available data on the epidemiology and pattern of heart disease in Sudan.MethodsData were obtained from the Sudan Household Survey (SHHS) 2006, annual health statistical reports of the Sudan Federal Ministry of Health, the STEPS survey of chronic disease risk factors in Sudan/Khartoum, and journal publications.ResultsThe SHHS reported a prevalence of 2.5% for heart disease. Hypertensive heart disease (HHD), rheumatic heart disease (RHD), ischaemic heart disease (IHD) and cardiomyopathy constitute more than 80% of CVD in Sudan. Hypertension (HTN) had a prevalence of 20.1 and 20.4% in the SHHS and STEPS survey, respectively. There were poor control rates and a high prevalence of target-organ damage in the local studies. RHD prevalence data were available only for Khartoum state and the incidence has dropped from 3/1 000 people in the 1980s to 0.3% in 2003. There were no data on any other states. The coronary event rates in 1989 were 112/100 000 people, with a total mortality of 36/100 000. Prevalence rates of low physical activity, obesity, HTN, hypercholesterolaemia, diabetes and smoking were 86.8, 53.9, 23.6, 19.8, 19.2 and 12%, respectively, in the STEPS survey. Peripartum cardiomyopathy occurs at a rate of 1.5% of all deliveries. Congenital heart disease is prevalent in 0.2% of children.ConclusionHeart diseases are an important cause of morbidity and mortality in Sudan. The tetrad of hypertension, RHD, IHD and cardiomyopathy constitute the bulk of CVD. Hypertension is prevalent, with poor control rates. A decline in rheumatic heart disease was seen in the capital state and no data were available on other parts of the country. No recent data on IHD were available. Peripartum cardiomyopathy and congenital heart disease occur at similar rates to those in other African countries.

Pattern of Cardiovascular Diseases as Seen in an Out-Patient Cardiac Clinic in Ghana

“…It is largely documented that hypertensive heart disease, rheumatic heart disease and cardiomyopathies are the major CVDs in sub-Saharan Africa [9] [11] [12] [13] [14], which is at variance with findings from the Western world where CVDs are largely due to coronary artery disease [15]. Furthermore, CVDs in sub-Saharan Africa are diseases of relatively younger people, with a high early mortality rate.…”

Clinical and sociodemographic characteristics of cardiovascular disease in Sudan

“…Similarly, the prevalence rate of low physical activity was 86.8% in the STEPS survey. 14 Cigarette smoking increases the impact of other risk factors (such as obesity, high cholesterol, diabetes, or older age) on the risk of coronary events. 23 The percentage of patients used tobacco and alcohol are less than those reported in the previous study.…”

“…[12][13][14][15] Large studies for identification of risk factors for cardiovascular disease among Sudanese subjects are not available and most of them are limited to 50-100 subjects.…”

Rheumatic heart disease in North Darfur: an alarmingly high burden and control initiative

“…It has been largely eliminated from high-income countries due to increased use of antibiotics coupled with improved living conditions and primary healthcare systems. In Sudan, RHD constitutes one of the major causes of heart disease in children and young adults [1]. Recently, echocardiographic (echo) screening has shown that the prevalence is high in certain areas in Sudan as in North Kordofan (62/1,000) [2].…”