Cardiovascular Journal of Africa: Africa STEMI Abstracts (April 2018)

4 / 16

CARDIOVASCULAR JOURNAL OF AFRICA • Africa STEMI Abstracts, April 2018 2 AFRICA
Presenting Author
Name: Mohamed Hasham
Surname: Varwani
Email
Contact Number +254721200196
Article
English Title
Preparedness towards acute coronary care in Kenya: A survey of the county hospitals
Category
Acute Coronary Syndromes
English Abstract
Introduction: Coronary artery disease and acute coronary syndrome (ACS) in combination are already a major cause of
death in subSaharan Africa with indication that they will become the leading cause of death by 2030. Successful manage-
ment of ACS is dependent on the timeliness of presentation, recognition of the condition and prompt institution of success-
ful therapy. The County Referral Hospital is the primary point of presentation for the vast majority of Kenyans with medical
emergencies. We set out to determine the level of preparedness of County hospitals in the country, for the management of
ACS and their potential complications.
Methods: We contacted frontline clinical staff at county hospitals distributed geographically across all Kenyan ‘provinces’
(outside the capital city, Nairobi) to determine access to expertise, to diagnostic and to therapeutic facilities at these
centers. A structured questionnaire was administered to provide information for each facility. Staff were asked about access
to ECG machines and cardiac enzyme testing, about their perceived expertise with regards resuscitation and ECG recogni-
tion, and about access to first line treatments including aspirin and thrombolysis, and about availability of critical care treat-
ment within the county hospital.
Results: Data were collected in February 2018. Medical officers and/or internists from 25 county hospitals providing a
broad geographical and administrative representation of Kenya were included in the survey. Two hospitals (8%) provide
ECG within 30 minutes and none of the units currently has cardiac enzymes on site. 13 (52%) of the clinicans participat-
ing reported active ACLS certification/training and felt confident using a defibrillator independently. Aspirin was stocked
for immediate use in 24 (96%) of the facilities and an alternative antiplatelet and heparin by 3 (12%) and 21(84%) of the
hospitals, respectively. None of the respondents reported any access to thrombolysis within 60 minutes. Two (8%) of the
surveyed county hospitals had a functioning defibrillator in the ER. A monitored unit was present in 4 of the 25 hospitals
surveyed (16%).
Conclusions: Most facilities surveyed appear at the moment to be insufficiently equipped for management of ACS. This
information indicates that healthcare providers and stakeholders must engage in ACS preparedness initiatives to meet the
demands of a rising prevalence of coronary artery disease.
Authors
Name & Surname Title Expertise Affiliation Email Country
Mohamed Hasham
Varwani Dr.
Cardiology
Fellow
Aga Khan University Hospital,
Nairobi Kenya
Ahmed Hassan Dr. Cardiology
Fellow
Aga Khan University Hospital,
Nairobi
Kenya
Mzee Ngunga Dr.
Consultant
Interventional
Cardiologist
Aga Khan University Hospital,
Nairobi
Kenya