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AFRICA
Cardiovascular Journal of Africa • Volume 31, No 4 August 2020
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hypertensive heart disease was 0.93% in 2017 (Table 1).
6
The
estimated age-standardised raised total cholesterol level (TC,
≥ 5.0 mmol/l) was 27.7% in 2008,
4
while in 2017, Zambians
aged 18–69 years old had a prevalence of only 7.4% (Table 1).
7
Physical activity
In 2016, the percentage of adolescents 11–17 years old who
were insufficiently active [< 60 minutes of moderate- to
vigorous-intensity physical activity (PA) daily] was 89.3%.
10
For adults, the age-standardised prevalence was 22.1%
of those who were insufficiently active (< 150 minutes of
moderate-intensity PA per week or < 75 minutes of vigorous-
intensity PA per week) in the same year (Table 1).
4
Overweight and obesity
The prevalence of overweight [body mass index (BMI) ≥ 25
to < 30 kg/m
2
] and obesity (BMI ≥ 30 kg/m
2
) in adults 25
years and older was 27.8 and 8.1%, respectively in 2016.
4
On
the other hand, of the STEPS respondents, 13.2% of men and
20.2% of women were overweight, while far more women
(12.3%) than men (3%) were found to be obese (Table 1).
7
Diabetes
The percentage of the defined population with a fasting
glucose level ≥ 7.0 mmol/l or on medication for raised blood
glucose (age-standardised) in 2014 was 6.5% for men and
6.7% for women.
4
In 2019, the prevalence of age-adjusted
(adults 20–79 years) diabetes was 4.5%, which is lower than
the global estimate of 9.3% but higher than that of Africa’s
3.9% (Table 1).
11
Part C: Clinical practice and guidelines
Health system capacity
Zambia had an average of 11.9 physicians and 13.4 nurses
per 10 000 of the population in 2018, and 20 hospital beds
Table 1. Cardiovascular disease indicators for Zambia
Indicators
Male
Female
Total
Year
Status of the national CVD epidemic
Premature CVD mortality (30–70 years old) (% deaths)
-
-
10
2012
Total CVD mortality (% of deaths)
9.8
10.9
10.3 (31.8)*
2017
DALYs attributable to CVD (%)
4.29
4.04
4.18 (14.7)*
2017
AF and atrial flutter (%)
0.12
0.09
0.1 (.5)*
2017
Total RHD mortality (% of deaths)
0.12
0.16
0.14 (.5)*
2017
Prevalence of RHD (%)
0.88
1.09
0.98 (.5)*
2017
Tobacco and alcohol
Prevalence of adult tobacco use (18–69 years old) (%)
#
24.0 (36.1)**
7.8 (6.8)**
-
2017
Prevalence of youth (13–15-year-olds) tobacco use (%)
24.9 (18.2)**
25.8 (8.3)**
-
2011
Estimated direct (healthcare-related) cost of tobacco use in your population
200 m
2019
(in current US$)
Proportion of premature CVD mortality attributable to tobacco (%)
-
-
4 (10)**
2004
Recorded alcohol consumption per capita (≥ 15 years) (litres of pure alcohol)
3.9
2016–18
(three-year average)
Raised blood pressure and cholesterol
Population with raised BP (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg)
20.5 (24.1)** 17.6 (20.1)** 19.1 (22.1)**
2017
(18–69 years old) (%)
#
Population with raised TC (≥ 5.0 mmol/l) (18–69 years old) (%)
#
4.5
9.3
7.4 (38.9)**
2017
DALYs attributable to hypertension (%)
2.01
2.7
2.32 (8.7)*
2017
Mortality caused by hypertensive heart disease (% of deaths)
0.63
1.33
0.93 (1.7)*
2017
Physical activity
Adolescents (11–17 years old) who are insufficiently active (< 60 minutes of moderate-
89.4
89.1
89.3 (80.7)**
2016
to vigorous-intensity PA daily) (%)
Adults (age-standardised estimate) who are insufficiently active (< 150 minutes of
19.1
25.0
22.1 (27.5)**
2016
moderate-intensity PA per week, or < 75 minutes of vigorous-intensity PA per week) (%)
Overweight and obesity (Adults 18–69 years old)
Prevalence of overweight (BMI ≥ 25–< 30 kg/m
2
) (%)
#
13.2
20.2
16.7 (38.9)**
2017
Prevalence of obesity (BMI ≥ 30 kg/m
2
) (%)
#
3.0
12.3
7.5 (13.1)**
2017
Diabetes
Defined population with fasting glucose ≥ 126 mg/dl (7.0 mmol/l) or on medication for
6.5 (9)**
6.7 (8)**
-
2014
raised blood glucose (age-standardised) (%)
Prevalence of diabetes (20–79 years old) (%)
-
-
4.5 (9.3)
##
2019
CVD, cardiovascular disease; DALYs, disability-adjusted life years; AF, atrial fibrillation; RHD, rheumatic heart disease; SBP, systolic blood pressure; DBP,
diastolic blood pressure; TC, total cholesterol; PA, physical activity; BMI, body mass index.
*IHME Global Health data exchange
6
**WHO global data
4
#
STEPS data
7
##
IDF
Diabetes Atlas
.
11