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Cardiovascular Journal of Africa • Volume 31, No 4 August 2020
S27
AFRICA
Rwanda Country Report
PASCAR and WHF Cardiovascular Diseases Scorecard
project
Joseph Mucumbitsi, Wihan Scholtz, Oana Scarlatescu, George Nel, Jean M Fourie
Rwanda Heart Foundation
Joseph Mucumbitsi
Pan-African Society of Cardiology (PASCAR), Cape Town,
South Africa
Wihan Scholtz,
wihan@medsoc.co.zaGeorge Nel
Jean M Fourie
World Heart Federation (WHF), Geneva, Switzerland
Oana Scarlatescu
Abstract
Data collected for theWorldHeart Federation’s Scorecard
project regarding the current state of cardiovascular
disease prevention, control and management along
with related non-communicable diseases in Rwanda
are presented. Furthermore, the strengths, threats,
weaknesses and priorities identified from these data
are highlighted in concurrence with related sections
in the attached infographic. Information was collected
using open-source datasets available online and relevant
government publications.
On behalf of the World Heart Federation (WHF), the Pan-
African Society of Cardiology (PASCAR) co-ordinated data
collection and reporting for the country-level Cardiovascular
Diseases Scorecard for use in Africa.
1,2
The Rwanda Heart
Foundation, with the assistance of its president and founder,
helped in collecting and verifying the data for Rwanda,
as one of the participating countries. In this report, we
summarise Rwanda’s strengths, threats, weaknesses and
priorities identified from the collected data, along with
needs to be considered in conjunction with the associated
sections in the accompanying infographic. Datasets used
included open-source data from the World Bank, the World
Health Organization (WHO), Institute for Health Metrics
and Evaluation, the International Diabetes Federation and
government publications.
Part A: Demographics
According to the World Bank (2018), Rwanda is a low-
income country with 83% of its people living in rural areas.
3
In 2013, about 56% of the population were living below the
US$1.9-a-day ratio. Life expectancy at birth in 2018 was
67 years for men and 71 years for women.
3
The general
government health expenditure in 2017 was 2.26% of the
gross domestic product (GDP), while the country GDP per
capita was US$772.9 in 2018.
4
Part B: National cardiovascular disease epidemic
The national burden of cardiovascular disease (CVD)
and non-communicable diseases (NCD) risk factors
Rwanda’s premature deaths attributable to CVD (30–70
years old) were similar to those of Uganda, Zambia and
Sudan at 10% in 2012.
1,5
In 2017, the age-standardised total
CVD death rate was 11.9%, which is slightly lower than the
neighbouring country, Tanzania (12.9%). The percentage
of disability-adjusted life years (DALYs) resulting from
CVD was 4.1 and 5.1% for men and women, respectively.
The percentage atrial fibrillation (AF) and atrial flutter was
0.12%, while that of rheumatic heart disease (RHD) was
1.0%. However, in 2013, 0.68% of school children, with
a mean age of 12.2 years, were identified with RHD.
6
The
total RHD mortality rate was 0.17% of all deaths in 2017
(Table 1).
7
Tobacco and alcohol
The prevalence of tobacco use in adult men and women
(≥ 15 years old) was 19.1 and 7.1%, respectively.
8
In the
13–15-year-old population, the prevalence was 13.3 and
9.5% in boys and girls, respectively, which is lower than
most African countries in our sample for which we have
data.
9
Data on the estimated annual direct cost of tobacco use
are not available. The premature CVD mortality attributable
to tobacco is 1% of the total mortality rate. The three-year
(2016–18) average recorded alcohol consumption per capita
(≥ 15 years) was 7.0 litres (Table 1).
4
Raised blood pressure and cholesterol
In the national 2012–2013 non-communicable diseases
STEP survey, 15.9% of the participants was identified
with raised blood pressure (BP) (systolic BP ≥ 140 mmHg
or diastolic BP ≥ 90 mmHg). Of these participants, 16.8%
were men and 15% women, while the rate among the 55–64-
year age group increased to almost 40%.
8
The percentage of
DALYs lost because of hypertension was 2.81%, whereas
mortality caused by hypertensive heart disease was 1.82%
DOI: 10.5830/CVJA-2020-03
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