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Cardiovascular Journal of Africa • Volume 31, No 4 August 2020
S49
AFRICA
Zambia Country Report
PASCAR and WHF Cardiovascular Diseases Scorecard
project
Fastone Goma, Wihan Scholtz, Oana Scarlatescu, George Nel, Jean M Fourie
Zambia Heart and Stroke Foundation (ZAHESFO), Lusaka,
Zambia
Fastone Goma
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 Zambia
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 Africa.
1,2
The Zambia Heart and Stroke
Foundation (ZAHESFO), a member of theWHF and PASCAR
collaborator, assisted the team in collating and verifying these
data. In this report, we review strengths, threats, weaknesses
and priorities identified from the collected data, along with
needs to be considered in conjunction with the associated
sections provided in the accompanying infographic. Datasets
that were 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 several government publications.
Part A: Demographics
According to the World Bank (2018), Zambia is a lower-
middle-income country with 56% of its people living in rural
areas.
3
In 2015, 57.5% of the population were living below
the US$1.9-a-day ratio. Life expectancy at birth in 2018
was 61 and 66 years for men and women, respectively. The
general government health expenditure was 1.73% of the
gross domestic product (GDP) in 2017, while the country’s
GDP per capita was US$1539.9 in 2018.
4
Part B: National cardiovascular disease epidemic
The national burden of cardiovascular disease (CVD)
and non-communicable diseases (NCD) risk factors
In comparison to the neighbouring countries, Tanzania and
Mozambique, Zambia’s premature deaths attributable to
CVD (30–70 years old) is 2% higher, at 10%.
5
In 2017, the
age-standardised total CVD death rate was 10.3%, which
is lower than the global rate of 31.8%.
6
The percentage of
disability-adjusted life years (DALYs) resulting from CVD
was 4.18%, with the prevalence of atrial fibrillation (AF)
and atrial flutter at 0.1%.
6
The prevalence of rheumatic heart
disease (RHD) was 0.98%, while the total RHD mortality
rate was 0.14% of all deaths (Table 1).
6
Tobacco and alcohol
The prevalence of tobacco use in adult men 15 years and
older was 26.5% in 2015, which, in 2017, was found to be
24% in 18–69-year-old respondents in the WHO STEPwise
approach to surveillance (STEPS).
4,7
In 2015, only 4.6% of
adult women used tobacco, while of those who participated in
STEPS, 7.8% was using tobacco.
4,7
The smoking prevalence
among adolescents aged 13–15 years was 24.9% for boys
and 25.8% for girls.
4
Country data available for the estimated
annual direct cost of tobacco use indicated approximately
US$200.
8
The premature CVD mortality rate attributable to
tobacco is 4% of the total mortality rate, which is lower than
the global 10%.
9
The three-year (2016–18) average recorded
alcohol consumption per capita (≥ 15 years old) was 3.9 litres
(Table 1).
4
Raised blood pressure and cholesterol
In 2015, the percentage of men and women 25 years and
older with raised blood pressure (BP) levels (systolic BP
≥ 140 mmHg or diastolic BP ≥ 90 mmHg) was 27.6 and
26.5%, respectively.
4
STEPS data, conversely, revealed
19.1% of Zambians had raised BP or were on medication
in 2017 (Table 1).
7
The percentage of DALYs lost because of
hypertension was 2.32%, whereas the mortality rate caused by
DOI: 10.5830/CVJA-2020-038