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AFRICA
Cardiovascular Journal of Africa • Volume 31, No 4 August 2020
S42
Uganda Country Report
PASCAR and WHF Cardiovascular Diseases Scorecard
project
Emmy Okello, John Omagino, Jean M Fourie, Wihan Scholtz, Oana Scarlatescu, George Nel,
Peter Lwabi
Past general secretary Uganda Heart Association, currently
head of the Department of Adult Cardiology, Uganda Heart
Institute, and assistant secretary for the Pan-African Society
of Cardiology (PASCAR) for East Africa
Emmy Okello
Past president Uganda Heart Association and executive
director, Uganda Heart Association
John Omagino
PASCAR, Cape Town, South Africa
Jean M Fourie
Wihan Scholtz,
wihan@medsoc.co.zaGeorge Nel
World Heart Federation (WHF), Geneva, Switzerland
Oana Scarlatescu
President Uganda Heart Association and deputy executive
director, Uganda Heart Institute
Peter Lwabi
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 Uganda
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 a country-level Cardiovascular
Diseases Scorecard to be used in Africa.
1,2
The Uganda
Heart Association, the Department of Cardiology and
Cardiac Catheterisation Laboratory at the Uganda Heart
Institute provided PASCAR with assistance with collating
and verifying these data, whereas the acting commissioner
in charge of the non-communicable diseases department at
the ministry of health (MoH) assisted with authenticating the
data. Open-source datasets from the World Bank, the World
Health Organization (WHO), Institute for Health Metrics
and Evaluation, the International Diabetes Federation and
government publications were used to collect data. Along
with these collected data, we review the strengths, threats,
weaknesses and priorities identified in conjunction with the
associated sections in the accompanying infographic.
Part A: Demographics
According to the World Bank (2018), Uganda is a low-
income country with 76% of its people living in rural areas.
3
In 2016, almost 41.7% of the population were living below
the US$1.9-a-day ratio. Life expectancy at birth in 2018 was
61 and 65 years, respectively, for men and women.
4
The
general government health expenditure was 1% of the gross
domestic product (GDP) in 2017, while the country GDP per
capita was US$642.8 in 2018.
4
Part B: National cardiovascular disease epidemic
The national burden of cardiovascular disease (CVD)
and non-communicable diseases (NCD) risk factors
Uganda’s premature deaths attributable to CVD (age 30–70
years) are the same as neighbouring country Rwanda at 10%
but higher than those of Tanzania (8%) and Ethiopia (6%).
5
In
2017, the age-standardised total CVD death rate was 9.85%,
which was lower than the global rate of 31.8%.
6
The total
rheumatic heart disease (RHD) mortality rate was 17.8% of
all deaths.
7
The percentage of disability-adjusted life years
(DALYs) resulting from CVD for men was 3.75% and 3.5%
for women. The prevalence of atrial fibrillation (AF) and atrial
flutter was 0.1%,6 while that of RHD was 2.97% (Table 1).
8
Tobacco and alcohol
The prevalence of tobacco use in adult men 15 years and
older was 16.4% in 2015, while adult women (2.9%) hardly
smoked.
4
However, STEPS data collected in 2014 indicated
9.6% of Ugandans, ages 18–69 years used tobacco, of which
16.8% were men.
9
Data available for the young smokers,
13–15 years old, revealed 19.3 and 15.8% boys and girls,
respectively smoked tobacco in 2011.
4,10
The estimated
annual direct cost of tobacco use was US$41.56 m in 2017.
4
The premature CVD mortality rate attributable to tobacco
was 2% of the total deaths, which is much lower than the
global 10%.
11
The three-year (2016–18) average recorded
alcohol consumption per capita (≥ 15 years) was 12.2 litres,
which is higher than most neighbouring countries (Table 1).
4
DOI: 10.5830/CVJA-2020-037