First Percutaneous Balloon Mitral Valvuloplasty in a Pregnant Patient in Tanzania.

Percutaneous balloon mitral valvuloplasty (PBMV) is a safe alternative to management of a pregnant woman with mitral stenosis. We report the first successful PBMV in a 27-year-old pregnant patient in Tanzania at 32 weeks gestation with NYHA functional class III symptoms. PBMV yielded excellent results.

The development of Africa's first unified hypertension management guidelines.

Hypertension is a leading cardiovascular risk factor, contributing significantly to morbidity and mortality in Africa. The continent is plagued with a high incidence, coupled with low treatment and control rates. The causes are multifactorial, and among the major causes is an absence of standardized African guidelines for the management of hypertension.

Evaluating the Effectiveness of African School of Hypertension for Non-Physician Health Workers, a Qualitative Study: QuASH Hypertension Study.

Background: The implementation of task sharing and shifting (TSTS) policy as a way of addressing the shortage of physicians and reducing the burden of hypertension in Africa birthed the idea of the African School of Hypertension (ASH). The ASH is saddled with the responsibility of training non-physician health workers across Africa continent in the management of uncomplicated hypertension.

Aim: To get feedback from some faculty members and students who participated in the first ASH programme.

Mid-level healthcare workers knowledge on non-communicable diseases in Tanzania: a district-level pre-and post-training assessment.

Introduction: Over the past two decades, Tanzania's burden of non-communicable diseases has grown disproportionately, but limited resources are still prioritized. A trained human resource for health is urgently needed to combat these diseases. However, continuous medical education for NCDs is scarce.

Task Sharing and Task Shifting (TSTS) in the Management of Africans with Hypertension: A Call For Action-Possibilities and Its Challenges.

Hypertension is a leading cause of mortality globally and one of the most common risk factors for cardiovascular disease. Diagnosis, awareness, and optimal treatment rates are suboptimal, especially in low- and middle-income countries, with attendant high health consequences and grave socioeconomic impact. There is an enormous gap between disease burden and physician-patient ratios that needs to be bridged.

Protocol for an evaluation of the initiation of an integrated longitudinal outpatient care model for severe chronic non-communicable diseases (PEN-Plus) at secondary care facilities (district hospitals) in 10 lower-income countries.

Introduction: The Package of Essential Noncommunicable Disease Interventions-Plus (PEN-Plus) is a strategy decentralising care for severe non-communicable diseases (NCDs) including type 1 diabetes, rheumatic heart disease and sickle cell disease, to increase access to care. In the PEN-Plus model, mid-level clinicians in intermediary facilities in low and lower middle income countries are trained to provide integrated care for conditions where services traditionally were only available at tertiary referral facilities. For the upcoming phase of activities, 18 first-level hospitals in 9 countries and 1 state in India were selected for PEN-Plus expansion and will treat a variety of severe NCDs.

Comparison between interventional versus medical therapy in patients with rheumatic mitral valve stenosis in Tanzania.

Background: Rheumatic heart disease remains the most common cardiovascular disease in children and young adults. The outcome of interventional versus medical therapy on the long term is not fully elucidated yet. This study provides contemporary data on the clinical profile, treatment and follow up of patients with rheumatic mitral stenosis (MS) in Tanzania.

Pregnancy risk and contraception among reproductive-age women with rheumatic heart disease attending care at a tertiary cardiac center in Tanzania: a hospital-based cross-sectional study.

Background: Rheumatic heart disease (RHD) remains prevalent in the developing world and reproductive-age women are disproportionately affected. It is among the common est cardiac diseases during pregnancy and is associated with poor pregnancy outcomes. Despite its importance among reproductive-age women, there are no local studies that characterize the clinical characteristics, risk of poor pregnancy outcomes and contraception which represents one effective way to prevent unplanned pregnancies in this population.

Prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among patients with rheumatic heart disease attending Jakaya Kikwete Cardiac Institute: a prospective cohort study.

Background: Arrhythmia is a known complication of rheumatic heart disease (RHD). It is critical to recognize arrhythmias early on so that prompt preventative actions and vigilant monitoring may be considered while treating these patients.

Aim: This study aimed at determining the prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among RHD patients attending Jakaya Kikwete Cardiac Institute (JKCI).

Health related quality of life of patients following mechanical valve replacement surgery for rheumatic mitral stenosis in Tanzania.

Background: The assessment of outcomes of interventions based on the patient's perspective using patient-reported outcome measures (PROMs) has been increasingly highlighted in clinical practice. However, health related quality of life (HRQoL), one of the common constructs measured by PROMs remain unknown among patients after heart valve replacement (HVR) in Tanzania.

Objectives: To assess the HRQoL amongst patients operated on for rheumatic mitral stenosis at Jakaya Kikwete Cardiac Institute (JKCI).

Sub-clinical rheumatic heart disease (RHD) detected by hand-held echocardiogram in children participating in a school-based RHD prevention program in Tanzania.

Background: Rheumatic Heart Disease (RHD) continues to cause suffering and premature deaths in many sub-Saharan Africa (SSA) countries, where the disease is still endemic. RHD is largely preventable and determining its community burden is an important critical step in any RHD prevention program.

Methods: We conducted a cross-sectional study of 5-16 years old pupils from 11 primary schools participating in an RHD prevention program in 4 districts in Tanzania, between 2018 and 2019.

Characteristics and immediate outcomes of patients who underwent percutaneous balloon mitral valvuloplasty at the Jakaya Kikwete Cardiac Institute, Tanzania.

Background: For rheumatic mitral stenosis (MS), a multidisciplinary evaluation is mandatory to determine the optimal treatment: medical, percutaneous balloon mitral valvuloplasty (PBMV) or valve surgery. Clinical and imaging evaluations are essential for procedural risk assessment and outcomes. PBMV interventions are increasingly available in Africa and are feasible options for selected candidates.

Risk Factors and Prevalence of Dilated Cardiomyopathy in Sub-Saharan Africa: A Systematic Review.

  Prevalence of DCM varies widely in SSA.Cardiovascular risk factors are important in patients with DCM.The role of genetics in idiopathic DCM is not studied in major part of SSA.

Infective endocarditis in developing countries: An update.

Introduction: Despite advances in diagnostic and treatment, morbidity and mortality due to infective endocarditis (IE) has not decreased. There is a discrepancy in epidemiology of IE between developed and developing countries. Over the last years, increased early detection and consequently prevalence of rheumatic heart disease (RHD) and congenital heart disease (CHD) which are considered predisposing conditions for IE, is noted.

Histopathological evaluation of chronic rheumatic mitral valve stenosis: the association with clinical presentation, pathogenesis, and management at a National Cardiac Institute, Tanzania.

Aims: The histopathology of mitral valve (MV) tissues have been reported in necropsy and retrospective studies. We prospectively studied the histopathological changes in rheumatic mitral stenosis using advanced techniques and corroborated these with clinical presentation, pathogenesis, and management.

Methods: From January 2020 to February 2021, surgically excised rheumatic stenotic MV from 54 Tanzanian patients were studied.

Statin Prescription Patterns and Associated Factors Among Patients with Type 2 Diabetes Mellitus Attending Diabetic Clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.

Purpose: To determine statin prescription patterns and associated factors among type 2 diabetes patients attending the diabetic clinic at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania.

Patients And Methods: A hospital-based cross-sectional study involving outpatients was conducted from September 2020 to November 2020. Statin prescription history (both type and dosage) was obtained from patients as well as from the electronic medical records for determination of patterns.

Rationale, design and protocol of a cross-sectional study on pregnancy-related cardiovascular diseases in Tanzania (PRECARDT): burden, characterisation and prognostic significance at delivery.

Introduction: The paucity of data describing cardiovascular disease (CVD) in pregnancy in many parts of Africa including Tanzania has given rise to challenges in proper management by the healthcare providers. This study is set out to (1) determine the prevalence of a range of CVDs during pregnancy in women attending antenatal clinics in Tanzania and (2) determine the impact of these CVDs on maternal and fetal outcomes at delivery.

Methods And Analysis: This is a cross-sectional study with a prospective component to be conducted in two referral hospitals in Tanzania.

Risk Factors and Prevalence of Dilated Cardiomyopathy in Sub-Saharan Africa: Protocol for a Systematic Review.

Background: Cardiomyopathies, defined as diseases involving mainly the heart muscles, are linked to an estimated 5.9 of 100,000 deaths globally. In sub-Saharan Africa, cardiomyopathies constitute 21.