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Letter to the Editor
Cohort studies of cardiovascular disease in the
Seychelles, Tanzania and Mauritius
We read with interest the review by Kengne
et al
. on cohort
studies of cardiovascular disease in sub-Sahara Africa.
1
We
agree with the authors that cohort studies are important tools to
advance our knowledge of cardiovascular disease in the region
and inform appropriate clinical and public health responses.
We recognise the difficult challenge of identifying all cohort
studies in the region. We wish however to mention several
cohort studies in the Seychelles, Tanzania and Mauritius, which
were published in leading medical journals but were not included
in the review, although they met inclusion criteria set by the
authors of the review.
The Republic of Seychelles, which lies in the Indian Ocean
around 1 000 km east of Kenya, belongs to south Saharan Africa.
Seychelles is part of WHO AFRO, is a member of the South
African Development Community (SADEC) and contributes
epidemiological data to the Global Burden of Disease project
for estimates of the east Africa region. The majority of the
population of Seychelles is of African descent.
In a cohort study of 5 514 Seychelles children, there was a
strong association between weight gain during the first year of
life and overweight/obesity at age five to 17 years.
2
Adherence to
antihypertensive treatment was low in 50 hypertensive patients
followed for 12 months, despite free healthcare.
3
In this study
adherence was measured with electronic pill containers, the gold
standard for assessment of therapeutic adherence. In a cohort
study of 153 smokers followed for six months, smokers who
were shown pictures of their own atherosclerotic plaques in their
carotid arteries (B-mode ultrasonography) had improved rates
of smoking cessation.
4
A cohort study among 644 Seychelles
children enrolled at birth showed no overall effect of pre-natal
exposure to organic mercury on blood pressure (BP) levels at age
12 and 15 years.
5
In Tanzania, 653 participants with BP
≥
160/95 mmHg
and 653 with BP
<
160/95 mmHg from a population survey
of 9 254 subjects in Dar es Salaam had BP readings on three
additional visits over an eight-week follow-up period. Their
BP decreased markedly over subsequent visits, irrespective of
baseline BP levels, and the prevalence of hypertension dropped
by approximately 50% based on BP values on the second, third
or fourth visits, compared to BP values on the first visit.
6
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