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Cardiovascular Journal of Africa • Volume 31, No 4 August 2020
S35
AFRICA
Tanzania Country Report
PASCAR and WHF Cardiovascular Diseases Scorecard
project
Robert Mvungi, Jean M Fourie, Oana Scarlatescu, George Nel, Wihan Scholtz
Tanzania Cardiac Society (TCS), Dar es Salaam, Tanzania
Robert Mvungi
Pan-African Society of Cardiology (PASCAR), Cape Town,
South Africa
Jean M Fourie
George Nel
Wihan Scholtz,
wihan@medsoc.co.zaWorld Heart Federation (WHF), Geneva, Switzerland
Oana Scarlatescu
Abstract
Data collected for the World Heart Federation Scorecard
project regarding the current state of cardiovascular
disease prevention, control and management, along
with related non-communicable diseases in Tanzania
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 from the World Bank, the World
Health Organization, Institute for Health Metrics and
Evaluation, the International Diabetes Federation 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 to be used in Africa.
1,2
Tanzania was
included as one of the countries and the Tanzania Cardiac
Society (non-WHF member) assisted with collating and
verifying the data. In this report, we summarise Tanzania’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 that were used included open-source
data fromtheWorldBank,WorldHealthOrganization (WHO),
Institute for Health Metrics and Evaluation, the International
Diabetes Federation and government publications.
Part A: Demographics
According to the World Bank (2018), Tanzania is a low-
income country with 66% of its people living in rural areas.
3
In 2011, 49.1% of the population were living below the
US$1.9-a-day ratio. Life expectancy at birth in 2018 was
63 years for men and 67 years for women. The general
government health expenditure was about 1.58% of the gross
domestic product (GDP) in 2017, while the country GDP per
capita was US$1061 in 2018.
3
Part B: National Cardiovascular Disease Epidemic
The national burden of cardiovascular disease (CVD)
and non-communicable diseases (NCD) risk factors
Tanzania’s premature deaths attributable to CVD (age
30–70 years) matched those of Kenya and Mozambique
at 8% in 2012.
4
In 2017, the age-standardised total CVD
death rate was almost 13%, which is higher than most of
the other African countries in our study. The percentage
of disability-adjusted life years (DALYs) resulting from
CVD for men was 5.07% and 4.63% for women. The
prevalence of atrial fibrillation (AF) and atrial flutter was
0.13%, while that of rheumatic heart disease (RHD) was
around 1%. The total RHD mortality rate was 0.14% of all
deaths (Table 1).
5
Tobacco and alcohol
The prevalence of tobacco use in adult men and women
(15 years and older) was 27.5 and 3.8%, respectively
(Table 1).
6
No data were available for the young population
(13–15-year-olds). However, in a representative sample of
school-going adolescents (≤ 12–≥ 18 years old), 8.2% were
using tobacco in 2014.
7
Most of these adolescents fell in
the 13–17-year age group.
7
For 2018, the estimated annual
direct cost of tobacco use was also not available,
6
while
the premature CVD mortality rate attributable to tobacco
was 3% of the total deaths.
8
The average recorded alcohol
consumption per capita (≥ 15 years old) for three years
(2016–18) was 7.3 litres (Table 1).
9
Raised blood pressure and cholesterol
The percentage of men and women with raised blood pressure
(BP) (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg)
in 2015 was 26.6 and 27.7%, respectively.
9
The percentage
of DALYs lost because of hypertension was 3.23%, whereas
mortality caused by hypertensive heart disease was 1.43%
in 2017 (Table 1).
5
Country data available for those with
raised total cholesterol (TC, ≥ 5.0 mmol/l; age-standardised
estimate) was 23.7% in 2008.
9
DOI: 10.5830/CVJA-2020-036