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Cardiovascular Journal of Africa • Volume 31, No 4 August 2020
S3
AFRICA
Mozambique Country Report
PASCAR and WHF Cardiovascular Diseases Scorecard
project
Albertino Damasceno, Ana O Mocumbi,Wihan Scholtz, Oana Scarlatescu, George Nel, Jean M Fourie
Heart Association of Mozambique
Albertino Damasceno
Instituto Nacional de Saúde, Mozambique
Ana O Mocumbi
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 by the Pan-African Society of Cardiology
for the World Heart Federation’s Scorecard project
regarding the current state of cardiovascular disease
prevention, control and management along with
related non-communicable diseases in Mozambique
are presented. Furthermore, the strengths, threats,
weaknesses and priorities identified from these data are
highlighted in concurrence with related sections in the
incorporated 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 to be used in Africa.
1,2
The Heart
Association of Mozambique (AMOCOR), a member of
PASCAR and the WHF, and the Division of Chronic and
Non-Communicable Diseases at the National Health Institute
in Mozambique assisted the PASCAR team in collating and
verifying these data. We used open-source datasets from the
World Bank, theWorld Health Organization (WHO), Institute
for Health Metrics and Evaluation, and the International
Diabetes Federation (IDF), along with relevant government
publications to collect information.
Part A: Demographics
According to the World Bank (2018), Mozambique is a
low-income country with 64% of its people living in rural
areas.
3
In 2014, almost 63% of the population were living
below the US$1.9-a-day ratio. Life expectancy at birth in
2018 was 57 years for men and 63 years for women.
3
The
general government health expenditure was 1.5% of the
gross domestic product (GDP) in 2017, while the country
GDP per capita was US$499 in 2018.
3
Part B: National cardiovascular disease epidemic
The national burden of cardiovascular disease (CVD)
and non-communicable diseases (NCD) risk factors
Mozambique’s premature deaths attributable to CVD (30–70
years old) were similar to Tanzania and Senegal at 8% in
2012, which is the second lowest after Ethiopia’s 6%.
4
In
2017, the age-standardised total CVD death rate was about
11.6%, which is lower than the neighbouring countries,
Tanzania (12.9%) and South Africa (16.1%).
5
The percentage
of disability-adjusted life years (DALYs) resulting from
CVD was 4.9%. The prevalence of atrial fibrillation (AF) and
atrial flutter was 0.1%, while that of rheumatic heart disease
(RHD) was 3.04%.
6
The total RHD mortality was 0.16% of
all deaths (Table 1).
5
Tobacco and alcohol
The prevalence of tobacco use in adult men and women
(≥ 15 years old) was about 22.8 and 3.2%, respectively.
7
Data
for the young population (13–15-year-olds) on tobacco use
came from the Global Youth Tobacco Survey (GYTS)
8
that
indicated a prevalence of 9.3 and 8.2% in boys and girls,
respectively. No data were available on the premature CVD
mortality attributable to tobacco or the estimated annual
direct cost of tobacco use (Table 1).
9
The three-year (2016–
18) average recorded alcohol consumption per capita (≥ 15
years) was 1.2 litres (Table 1).
10
Raised blood pressure and cholesterol
The percentage of men and women, 15–64 years old, with
raised blood pressure (BP) (systolic BP ≥ 140 or diastolic
BP ≥ 90 mmHg) was 31.2 and 31.5%, respectively, while
the overall prevalence among those aged 25–64 years was
38.9% in 2015.
7,11
The percentage of DALYs lost because
of hypertension was 3.5%, whereas mortality caused by
hypertensive heart disease was 1.13% in 2017.
5
The estimated
age-standardised raised total cholesterol (TC ≥ 5.0 mmol/l)
in 2008 was 26% (Table 1).
10
DOI: 10.5830/CVJA-2020-032