CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 2, March/April 2022 90 AFRICA chaired by the current WHF president, Prof Fausto Pinto, brought together a wealth of perspectives and expertise from across Africa where the consequences of urbanisation, decreased levels of physical activity, shifting diets and increased economic growth have made obesity a looming public health crisis. The summit had three plenary sessions that outlined the factors contributing to the rising obesity rates in Africa. These included a showcase on what people living with CVDs and obesity can teach the cardiovascular community about managing complex conditions; discussions specific to breaking down how health systems on the continent can shift from managing communicable disease to preventing and managing non-communicable diseases; and deliberations on current and future directions for effective research and collaboration between cardiologists, endocrinologists and physicians in combating the rise in obesity-related cardiometabolic diseases. Global statistics show that obesity is growing as a prominent health challenge around the world, and specifically on the African continent,2 with an emphasis among the low- and middle-income classes in Africa’s urban cities. Eight of the 20 fastest-rising countries with adult obesity are in Africa.2 The speakers emphasised the importance of advocacy around healthy lifestyle education, including the importance of dietary patterns in disease modification, as demonstrated through diabetes reversal programmes and in preventative medicine research.3 One of the speakers representing the youth emphasised the need to destigmatise obesity through encouraging young people to talk about obesity with each other, their communities and local healthcare providers and, furthermore, the need to establish safe and accessible nutrition and physical activity programmes targeting this population. This was particularly impactful to engage with and empower members of the youth in these discussion, as rates of childhood and adolescent obesity are growing exponentially in the region and are projected to increase in the coming decades.4 The summit also explored the gender-based differences in rates of physical activity, general fitness and engagement in routine exercise, with specific focus on addressing the challenges and cultural barriers faced among women in Africa. It was unanimously agreed that there was a need to create awareness on obesity and its connection to cardiovascular and metabolic diseases with a focus on primary prevention, destigmatisation and advocacy programmes, and strategic community engagement. PASCAR Africa heart failure course 2021 workshop The PASCAR Africa heart failure course 2021 was launched on 27 March 2021. The course is delivered in partnership with Cardiff University. The course has been developed for Africa by Africans, with the aim to create a network of appropriately trained specialists with an interest in heart failure to take leadership roles in their region, country and local institutions. The inaugural course enrolled 22 candidates: 15 cardiologists, three cardiovascular disease fellows and four specialist medical physicians from across Africa. The course attendees represented various African countries, including Kenya, Tanzania, Senegal, Sierra Leone, Ghana, Nigeria, Cameroon, Rwanda, Zambia, Zimbabwe, South Africa, Sudan, Uganda and Mozambique. The candidates are expected to develop systems of care designed to offer early diagnosis and optimise treatment, without undue burden on resources, through capacity-building initiatives. The programme was delivered virtually on the last weekend of each month between March and September 2021. The course included 50 hours of didactic talks and interactive discussions, as well as case presentations by candidates, which were critically reviewed by faculty mentors and peers. As part of the course, participants attended the joint PASCAR and KCS congress. During the congress, this pre-conference workshop was organised for further face-to-face training, collaboration and mentorship. In this session, co-ordinated by Prof Mahmoud Sani, some selected participants presented a synopsis of their research work, which is a requirement for completing the course, titled ‘A description of my current heart failure landscape and evidence-based approaches to improve services’. Drs Isa Oboirien, (Nigeria), Irina Mbanze (Mozambique), Nafisa Elsammani (Sudan), Amha Weldehana (Rwanda), Ido Ukpeh (Nigeria) and Theresa Ruba Koroma (Sierra Leone) presented papers. They all highlighted challenges of heart failure services in their countries and recommended ways of improvement. The leadership of the PASCAR heart failure task force is working with the presenters to publish a summary of this work. During the meeting, the peculiarities of heart failure on the African continent were discussed. Heart failure in Africa is associated with higher age-adjusted mortality and patients are two decades younger than their counterparts in Europe and America.5 This has very important implications for the continent as heart failure affects young people in their economically productive ages. It also has mainly non-ischemic aetiology with hypertension, dilated cardiomyopathy, rheumatic heart disease, HIV-associated cardiomyopathy and pericardial disease being common risk factors.6 In addition, heart failure in Africa is more common among men, where hypertensive heart disease is prevalent and more common among women in areas where rheumatic heart disease and peripartum cardiomyopathy are common.7 Also mentioned was the rising incidence of heart failure among people over the age of 60 years, which is associated with higher rates of morbidity, hospital admission and mortality, and lower overall quality of life.7 Clinical research training course on cohort studies in Africa The pre-congress short course was organised by Prof Friedrich Thienemann (South Africa) and Prof Anastase Dzudie (Cameroon). The lecturers covered methods and experience on cohort study research in Africa.8 The sessions were delivered through didactic lectures and pre-recorded video presentations by pre-eminent invited faculty speakers. Prof Thienemann introduced phase II of the Pan-African Pulmonary Hypertension Cohort study (PAPUCO II).9,10 He emphasised the need to focus on pulmonary hypertension associated with infectious diseases, such as HIV, tuberculosis, schistosomiasis and rheumatic heart disease, and to increase the recruitment target to 1 000 participants by inviting more centres from more countries to join the study. Prof Anastase Dzudie discussed the various study designs and the ‘A to Z’ of study proposal development. He pointed out that a clear understanding of the research question ultimately leads to appropriate outcomes. Prof Karen Sliwa, past president of the WHF, gave a lecture discussing cohort studies in minors and pregnant women. She
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