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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 5, September/October 2019
AFRICA
305
PASCAR and WHF Cardiovascular Diseases Scorecard
project
Awad A Mohamed, Jean M Fourie, Wihan Scholtz, Oana Scarlatescu, George Nel, Saad Subahi
Abstract
On behalf of the World Heart Federation, the Pan-African
Society of Cardiology (PASCAR) co-ordinated data collec-
tion and reporting for the country-level Cardiovascular
Diseases (CVD) Scorecard to be used in Africa. The objective
of the scorecard is to create a clear picture of the current state
of CVD prevention, control and management per country
for 12 African countries. The Sudan Heart Society assisted
PASCAR in collating and verifying the data through Drs
Awad Mohamed (president, Sudan Heart Society) and Saad
Subahi (PASCAR president, based in Sudan). Based on the
data collected, we summarise the strengths, threats, weak-
nesses and priorities identified, which need to be considered
in conjunction with the associated sections provided in the
infographic published with this report. Data sets used includ-
ed open-source data from the World Bank, World Health
Organisation and government publications.
Cardiovasc J Afr
2019;
30
: 305–310
www.cvja.co.zaDOI: 10.5830/CVJA-2019-063
Part A: Demographics
According to the World Bank (2018), Sudan is a lower-middle-
income country with 66% of its people living in rural areas. In
2009, 14.9% of the population were living below the US$1.9-
a-day ratio. Life expectancy at birth in 2016 was 63 years for
men and 66 years for women. The general government health
expenditure was 1.97% of the gross domestic product (GDP)
in 2015, while the country GDP per capita was US$2 898.5 in
2017.
1
Part B: National cardiovascular disease epidemic
National response to cardiovascular disease (CVD)
and non-communicable diseases (NCD)
In comparison to neighbouring countries Ethiopia and Egypt
(6 and 16%, respectively), Sudan’s premature deaths attributable
to CVD (age 30–70 years) centred at 10% in 2010. In 2017, the
age-standardised total CVD death rates were high at 33.03%, which
was lower than that of Egypt at almost 47% but slightly higher
than the 31.8% for the Global Burden of Disease (GBD) data.
2
The percentage of disability-adjusted life years (DALYs) resulting
from CVD for men was 12.69% and for women 11.74%, which is
lower than the GBD at 14.66% for both genders. Atrial fibrillation
(AF) and arterial flutter was 0.14%, while the prevalence of
rheumatic heart disease (RHD) was 0.64% compared to that of
the GBD data (0.53%). The total RHD mortality rate was 0.38%
of all deaths, which is lower than the GBD data (0.51%) (Table 1).
2
Tobacco and alcohol
The prevalence of tobacco use in adult men and women (15+
years old) was 27.9 and 0.8%, respectively.
3
Comparative Global
Health Observatory (GHO) data are 36.1% for men and 6.8%
for women.
4
In the young population (13–15 years old) the
prevalence was 9.5% in boys and 4.3% in girls, which is the
lowest among those African countries in our sample for which
we have data.
4
This prevalence is also lower than the GHO data.
4
For 2018, the estimated annual direct cost of tobacco use was
US$5.91.
3
The premature CVD mortality attributable to tobacco
is 1% of the total mortality rate and much lower than that of the
global 10%. The three-year (2015–2017) average recorded alcohol
consumption per capita (15+ years) was 0.0 litres (Table 1).
4
Raised blood pressure and cholesterol
STEPS data released in 2018 indicated 31% of men and 32.1% of
women had raised blood pressure levels [systolic blood pressure
(SBP)
≥
140 or diastolic blood pressure (DBP)
≥
90 mmHg],
3
which is higher than the respective GHO levels of 24.1 and
20.1%.
4
Conversely, the percentage of individuals with raised total
cholesterol levels (
≥
5.0 mmol/l or currently on medication for
raised cholesterol) was 13.6% compared to GHO data (38.9%).
3,4
The percentage of DALYs lost because of hypertension was
7.49%, the mortality rate caused by hypertensive heart disease
(2.15%) was higher compared to the 1.65% for global data in
2017 (Table 1).
2
Department of Medicine, University of Khartoum,
Khartoum, Sudan
Awad A Mohamed, MD
Pan-African Society of Cardiology, Cape Town, South Africa
Jean M Fourie
Wihan Scholtz,
wihan@medsoc.co.zaGeorge Nel
World Heart Federation, Geneva, Switzerland
Oana Scarlatescu
College of Medicine, National University, Khartoum, Sudan
Saad Subahi, MD
Sudan Country Report