CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 5, May 2013
14
AFRICA
START YOUNG, PREVENTION IS BETTER THAN CURE:
THE USE OF VIDEOS TO PREVENT CHRONIC DISEASES
OF LIFESTYLE IN SOWETO
Lamont KT*, Pretorius S, Albertyn Z, Nicholson L, Sliwa K
NIH Millennium Leadership Programme for Chronic Diseases,
Soweto Cardiovascular Unit, University of the Witwatersrand,
Johannesburg, South Africa
Introduction:
Goal 2 of the South African Millenium Goals is to
achieve universal education and to ensure that, by 2015, children
everywhere, boys and girls alike, will be able to complete a full
course of primary schooling. For South Africa, poor education and
poverty has given many learners the misconception that healthy
foods are too expensive. A pilot study was performed in Soweto
(Ibhongo Secondary School).
Subjects and methods:
The aim was to address poor diet of learn-
ers from disadvantaged backgrounds and to determine their inter-
est in health information via technological interventions. A health
questionnaire was administered to 66 pupils. The questionnaire was
explained to the pupils by postgraduates students. A healthy eating
demonstration was given by a dietician. Thereafter 3 short clips that
were developed by the Hatter Institute, in conjuction with Soweto
Cardiovascular Unit were shown.
Results:
Starch intake was excessive with maize meal and bread as
the staple diet for many; 35% of learners ate ‘pap’ daily and 33%
consumed bread. Processed foods were eaten a minimum of 3 times
a week; 28% of learners consumed confectionery daily. Over 50% of
the learners added extra salt to their meals. Green leafy vegetables
were consumed by 12% of learners who ate vegetables <3 times a
week. When protein intake was assessed, only 20% of the learners ate
either chicken or meat daily. Frozen fish was perceived to be more
expensive and 3% of learners ate fish <3 times a week. Tinned fish
was popular among the learners with over 30% consuming tinned
fish at least once a week or more. The use of IT as an educational
tool to coach learners on how to eat healthily for less was remarkable:
61% of the leaners were interested in accessing information via the
internet, 35% were interested in receiving health messages, and 84%
preferred the healthy videos that were screened.
Interpretation:
Health education has become the foundation for
preventing chronic diseases. The use of technological interventions
such as fluid, flexible solutions for the dissemination of health infor-
mation to all, in the form of health videos can be used to address the
poor diet of learners from disadvantaged backgrounds.
CARDIOMETABOLIC PHENOTYPEANDARTERIALSTIFF-
NESS IN HIV-POSITIVE BLACK AFRICAN PATIENTS
Lemogoum D*, Ngatchou W, Ndobo P, Yiagnigni E, Tiogou E, Nga
E, Kouanfack C, Van Bortel L, Degaute JPI, van de Borne, Michel
Hermans P
Service of Cardiology, ULB-Erasme Hospital, Brussels, Belgium
Introduction:
Human immunodeficiency virus (HIV) infection
and/or HIV therapy may promote a metabolic syndrome (MetS)
phenotype. In Caucasian patients, HIV infection is associated with
increased aortic stiffness measured by pulse wave velocity (PWV).
We therefore hypothesised that HIV infection in black African
patients is associated with increased cardiometabolic risk factors that
may increase aortic stiffness.
Subjects and methods:
We matched 96 Cameroonian controls with
238 HIV-positive patients (HIV) for age. In each participant, aortic
PWV (ComplioR), blood pressures (BP), lipid profile and fasting
blood glucose (FPG) were measured. Waist circumference was lower
in HIV than in control group (both
p
<0.001).
Results:
The prevalences of impaired FPG (100–125 mg.dl
-1
), and
of diabetes (FPG >125 mg.dl
-1
) were higher in HIV than in controls
(50% v. 27%, and 23% v. 1%, respectively; both
p
<0.0001). HDL-C
was lower in HIV than in controls (
p
=0.02). Fasting triglycerides
(TG) and the atherogenic dyslipidemia ratio [log (TG)/HDL-C]
were higher in HIV than in controls (both
p
<0.05). Hypertension
prevalence was high but comparable in the two groups (48% v. 44%
respectively,
p
>0.05). HIV patients exhibited a twice-higher preva-
lence of MetS (AHA/NHLBI score ≥3/5) than controls (41% v. 21%;
p
<0.01). Similarly, severity of MetS phenotype was higher in HIV
than in controls (2.14% v. 1.59%;
p
<0.0001). PWV adjusted for age,
mean BP and gender was faster in HIV than in controls (7.33 m/s v.
6.86 m/s, respectively;
p
=0.036).
Interpretation:
HIV infection is associated with higher prevalence
of MetS and its phenotype in black African patients that may induce
early arterial damage translated by increased aortic stiffness.
EFFECTS OF NEWER V. OLDER ANTIHYPERTENSIVE
DRUGS ON CENTRAL HAEMODYNAMICS IN BLACK
HYPERTENSIVE PATIENTS LIVING IN SUB-SAHARAN
AFRICA: INSIGHT FROM NOAAH STUDY
Lemogoum D*, Jacobs,B Anisiuba B, Kamdem MM, Thijs L,
Kaptue J, Odili AN, Ezeala-Adikaibe B, M’Buyamba-Kabangu JR,
Ulasi II, Staessen JA
Service of Cardiology, ULB-Erasme Hospital, Brussels, Belgium
Introduction:
The Newer versus Older Antihypertensive agents
in African Hypertensive patients (NOAAH) trial was designed to
compare the efficacy of single-pill combinations of amlodipine-
valsartan 5/160 mg (E) and bisoprolol-hydrochlorothiazide 5/6.25
mg (R) drugs on blood pressure (BP) in native black patients living in
sub-Saharan Africa. Furthermore, the present ancillary study aimed
to explore the effects of E and R drugs on central haemodynamics
in 80 of 183 randomised patients (40 per drug arm) aged 30–69
years with uncomplicated hypertension (140–179/90–109 mmHg)
recruited from two NOAAH centres.
Subjects and methods:
Central pressures, systolic augmentation,
augmentation index (AIx), carotid-femoral pulse wave velocity
(PWV) were measured using applanation tonometry (SphygmoCor)
at inclusion, after 8 and 16 weeks of treatment.
Results:
At randomisation age, sex, BP, AIx, and heart rate (HR)
were comparable in both regimens, while PWV was faster in E
than R (
p
=0.02). Despite similar changes in brachial BP, aortic
systolic augmentation was less in E than R: difference = -2.8 mmHg
(95% confidence interval (CI) -4.8 to -0.8),
p
=0.007, while E non-
significantly lowered more aortic systolic pressure than R: difference
= -4.6 mmHg (95% CI -9.6 to 0.5),
p
=0.078. Central pulse pres-
sure decreased markedly in the E than R: mean changes = -8.4 ±
1.9 mmHg v. -3.4 ± 2.4 mmHg,
p
=0.008. AIx standardised for HR
significantly decreased in E, whereas it increased in R: mean changes
= -8.4 ± 1.6% v. 5.4 ± 5.5%,
p
=0.0007. Change in PWV was similar
between both drug arms (
p
=0.82).
Interpretation:
In black patients the amlodipine-valsartan regimen
decreases more central pressures and AIx than the bisoprolol-hydro-
chlorothiazide combination.
ENDOCARDITES INFECTIEUSES: ETUDE RETRO-
SPECTIVE MULTICENTRIQUE AU CHU DE FANN ET A
L’HOPITAL D’ENFANTS ALBERT ROYER DE DAKAR
INFECTIVE ENDOCARDITIS: A RETROSPECTIVE MULTI-
CENTRE STUDY AT THE FANN UNIVERSITY HOSPITAL
AND THE ALBERT ROYER CHILDRENS’ HOSPITAL IN
DAKAR
Leye M*, Diop IB, Sarr EHM, Manga S, Diallo AD, Diene LL
Clinique Cardiologique CHU Fann, Dakar, Senegal
Introduction:
L’endocardite infectieuse (EI) se définit par des
lésions plus ou moins étendues de l’endocarde, provoquées par des
micro-organismes. En Afrique, elle demeure une affection grave par
ses complications hémodynamiques, infectieuses et emboliques.     
Subjects and methods:
Notre travail est une étude rétrospective
multicentrique. Durant la période de Janvier 2007 à Décembre 2010,
nous avons inclus tous les patients ayant une endocardite infectieuse
1...,6,7,8,9,10,11,12,13,14,15 17,18,19,20,21,22,23,24,25,26,...40