In sub-Saharan Africa (SSA), a rising burden of noncommunicable diseases (NCDs) coexists with a persistent high burden of human immunodeficiency virus (HIV). Integrating care for chronic conditions is potentially beneficial, but the optimal approach remains unclear. By use of a narrative review of 14 recent case studies from different SSA countries, examples of NCD and HIV healthcare integration were described.
View Article and Find Full Text PDFIntroduction/background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The AF Atrial Fibrillation Registry, which commenced in June 2023, was designed to provide clinical epidemiological data on patients with AF in the country.
Objective(s): The objective is to describe the rationale, design, and early findings from the registry.
Introduction/background: Chronic heart failure (CHF) has important gender-specific aspects, which are worthy of note, as they influence the haemodynamic state of patients the choice of therapy, aetiology, and clinical outcomes. Women are less frequently represented in CHF studies and clinical trials than males. While some published data are conflictive, more studies tailored to this critical discourse are necessary to inform patient care and improve outcomes in patients with CHF.
View Article and Find Full Text PDFBackground: Single-pill combinations (SPCs) of three low-dose antihypertensive drugs can improve hypertension control but are not widely available. A key issue for any combination product is the contribution of each component to efficacy and tolerability. This trial compared a new triple SPC called GMRx2, containing telmisartan, amlodipine, and indapamide, with dual combinations of components for efficacy and safety.
View Article and Find Full Text PDFBackground: In line with the WHO Global Action Plan's objective to achieve a 30% relative reduction in the mean population intake of sodium by 2025, the Nigeria Sodium Study (NaSS) team, which aimed to evaluate the implementation and scale-up of national sodium reduction programme, hosted a policy meeting May 22, 2023, in Abuja, the Federal Capital Territory of Nigeria. The aim was to deliberate on strategies for translating data on salt levels in food and dietary patterns, intending to strengthen sodium policies in Nigeria, with the ultimate goal of producing evidence-based information that can effectively guide strategies and policies for sodium reduction.
Methods: Policymakers from federal, state, and local government levels attended, as well as representatives from national and international universities and non-governmental organizations.
Background: Healthcare workers (HCWs) including community health extension workers (CHEWs) in the Federal Capital Territory, Nigeria participated in a hypertension training series following the Extension for Community Healthcare Outcomes (ECHO) model which leverages technology and a practical peer-to-peer learning framework to virtually train healthcare practitioners. We sought to evaluate the patient-level effects of the hypertension ECHO series.
Methods: HCWs from 12 of 33 eligible primary healthcare centers (PHCs) in the Hypertension Treatment in Nigeria Program (NCT04158154) were selected to participate in a seven-part hypertension ECHO series from August 2022 to April 2023.
Importance: With the high burden of hypertension in sub-Saharan Africa, there is a need for effective, safe and scalable treatment strategies.
Objective: To compare, among Black African adults, the effectiveness and safety of a novel low-dose triple-pill protocol compared with a standard-care protocol for blood pressure lowering.
Design And Setting: Randomized, parallel-group, open-label, multicenter trial conducted in public hospital-based family medicine clinics in Nigeria.
Background: Blood pressure (BP) control among treated patients in Africa is very suboptimal, with low levels of combination therapy use and therapeutic inertia being among the major barriers to effective control of hypertension. The VERONICA-Nigeria study aims to evaluate, among Black African adults with hypertension, the effectiveness and safety of a triple pill-based treatment protocol compared to Nigeria hypertension treatment protocol (standard care protocol) for the treatment of hypertension.
Methods: This study involves a randomized, parallel-group and open-label trial.
We performed a systematic review and meta-analysis of hypertension in people living with human immunodeficiency virus (HIV) in sub-Saharan Africa (SSA). We searched the PubMed, Google Scholar, African Index Medicus, and Embase databases to identify studies published from January 1, 2010, to December 31, 2021. We used a random-effects model to estimate the pooled prevalence of hypertension and mean SBP/DBP level on a sex-specific basis.
View Article and Find Full Text PDFIntroduction: Noncommunicable diseases (NCDs) are associated with high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related deaths worldwide and is a foremost public health problem in Nigeria. As part of National policy, Nigeria has committed to implement the World Health Organization (WHO) Package of Essential Non-communicable Disease interventions for primary care.
View Article and Find Full Text PDFBackground: There is minimal data on the number of adolescents in sub-Saharan Africa (SSA) with elevated blood pressure (BP) at increased risk of future cardiovascular events. Combining country-specific population data with data derived from two previously conducted meta-analyses (one African-specific, one based on international cohorts), we sought to address this knowledge deficit.
Methods: We used meta-analysis data from 37 926 adolescents participating in 36 contemporary SSA studies to generate sex-specific proportions of adolescents aged 10-14 and 15-19 years with elevated BP.
Introduction: Noncommunicable diseases (NCDs) are associated with a high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related deaths worldwide and is a foremost public health problem in Nigeria. As part of the National Multi-Sectoral Action Plan for the Prevention and Control of NCDs, Nigeria has committed to implementing the World Health Organization (WHO) Package of Essential NCD control interventions.
View Article and Find Full Text PDFBackground: The Extension for Community Health Outcomes (ECHO) model has been used extensively to link care providers in rural communities with experts with the aim of improving local patient care.
Objective: The aim of this qualitative research study was to assess the feasibility, acceptability, perceived needs, and contextual factors to guide implementation of a hypertension focused ECHO program for Community Health Extension Workers (CHEWs) in the Federal Capital Territory, Nigeria.
Methods: From September 2020 to December 2020, key informant interviews were performed with seven global organizations (hubs) providing ECHO training focused on cardiovascular disease or nephrology to identify contextual factors and implementation strategies used by each hub.
Background: Nigeria has one of the highest burdens of maternal deaths globally, and hypertensive disorders of pregnancy (HDP) are the leading cause of maternal morbidity and mortality in the country. There is a significant implementation gap in utilizing evidence-based practices for the management of HDP in Nigeria. This study evaluated facilitators and barriers to implementing a home blood pressure monitoring program to improve management of HDP.
View Article and Find Full Text PDFPurpose Of Review: Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality globally with an accelerated increase in CVD‑related death in Africa and other low‑middle‑income countries. This review is aimed at highlighting the burden of coronary artery disease CAD, its peculiarities as well as challenges of management in sub-Saharan Africa.
Recent Findings: Recent data revealed a shift from high incidence of CVDs associated with poverty and malnutrition (such as rheumatic heart disease) initially, which are now falling, to rising incidence of other non-communicable CVDs (such as hypertension, coronary artery disease (CAD), and heart failure).
Background: There is rekindled interest in the cardiotoxicity of antimalarial medicines. Halofantrine is associated with QT interval prolongation. Fluconazole and kolanut alter the pharmacokinetics of halofantrine.
View Article and Find Full Text PDFBackground: More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries. However, there is a paucity of data on the pattern of elevated blood pressure among adolescents aged 10-19 years in sub-Saharan Africa. We aimed to provide pooled estimates of high blood pressure prevalence and mean levels in adolescents aged 10-19 years across sub-Saharan Africa.
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