![Show Menu](styles/mobile-menu.png)
![Page Background](./../common/page-substrates/page0065.png)
CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 4, July/August 2018
AFRICA
263
cardiologist (AO Mocumbi), to participate in the feasibility
study with a 10-year follow up. The presence of this Ugandan
colleague was particularly important to strengthen the capacity
of the Mozambican team to perform cardiac ultrasound in
the field, a crucial part of the follow-up study that can only be
performed by the 16 existing cardiologists in Mozambique.
This exchange occurred between 5 and 16 September 2017 in
Maputo city and in the rural district of Inharrime, located 400
km from Maputo. The study was co-funded by the NPHI and
UHI, as well as the Aswan Heart Centre and Chain of Hope,
where EMF surgery will potentially be done for selected patients,
owing to the presence of Prof Magdi Yacoub, who has in-depth
experience on the surgical approach to the disease and mentored
Mocumbi in her post-graduate studies.
12,14
This personnel link
has now been used to promote exchange of researchers between
Mozambique, Uganda and Egypt, through projects focusing on
the epidemiology and management of EMF.
Research mentorship consisted of skills transfer in grant
application processes, including acquisition of unique Data
Universal Number System (DUNS) number, data management,
budgeting and use of electronic platforms for data entry. The use
of research administration number (eRA Commons D) was also
introduced to Namuyonga.
The mentor (Mocumbi) and the mentee/fellow (Namuyonga)
travelled from Maputo to Inharrime where the team held
several preparatory meetings with the village local leaders and
did house-to-house visits. Portuguese is the national language
and was the most frequently used medium of communication,
which was a limitation to Namuyonga during the family visits.
Therefore she was in charge of performing cardiac ultrasound
while Mocumbi consulted participants, collected clinical history
and took verbal autopsy, whenever applicable.
Using GPS, we were able to find all houses previously visited,
and have obtained consent from all heads of households. In this
early study phase, we visited 25 locations from four administrative
areas, where we performed 31 cardiac ultrasounds.
Extreme poverty was noted in this geographic area, coupled
with the dry tropical weather. Few gardens of cassava were seen,
most people could only afford a single meal a day, and there was
low access to clean water.
Immediate outcomes
This report demonstrates the feasibility of collaboration
between LICs in sub-Saharan Africa, including clinical research
mentorship, the conduction of high-quality, patient-orientated
research, and community-based research. Immediate outcomes
were the reinforcement of Mozambique’s capacity for performing
field ultrasound, creation of a network of three African countries,
and the initiation of other projects on cardiovascular risk factors
in young populations.
As African trainees do not easily get hands-on training
in affluent/well-developed nations, this kind of collaboration
could be one of the avenues to overcome this problem in
certain areas of clinical and research training. South-to-south
research collaboration projects may be a platform to foster
these partnerships and promote efficient use of resources in
underserved areas.
References
1.
Mocumbi AO. African experiences of humanitarian cardiovascular
medicine: the Mozambican experience.
Cardiovasc Diagn Ther
2012;
2
(3): 246–251.
2.
Valfrey MV, Umarji MB. Sector Budget Support in Practice: Health
Sector in Mozambique, 2010.
3.
Okello E, Longenecker C, Beaton A, Kamya MR, Lwabi P. Rheumatic
heart disease in Uganda: predictors of morbidity and mortality one year
after presentation.
BMC Cardiovasc Disord
2017;
17
: 20.
4.
Mocumbi AO, Ferreira MB, Sidi D, Yacoub MH. A population study
of endomyocardial fibrosis in a rural area of Mozambique.
N Engl J
Med
2008;
359
: 43–49.
5.
Aliku TO, Lubega S, Namuyonga J, Mwambu T, Oketcho M, Omagino
JO,
et al
. Pediatric cardiovascular care in Uganda: Current status, chal-
lenges, and opportunities for the future.
Ann Pediatr Cardiol
2017;
10
(1):
50–57.
6.
Davies JNP. Endomyocardial fibrosis in Uganda.
East Afr Med J
1948;
25
: 10–16.
7.
Davies JNP, Ball JD. The pathology of endomyocardial fibrosis.
Br
Heart J
1955;
17
(3): 337–359.
8.
Somers K. Proceedings of the 3rd Asian Pacific Congress on Cardiology.
Int J Cardiol
1964;
1
: 162.
9.
Beaton A, Sable C, Brown J, Hoffman, Mungoma M, Mondo C,
et
al
. Genetic susceptibility to endomyocardial fibrosis.
Glob Cardiol Sci
Pract
2014: 60.
10. Grimaldi A, Mocumbi AO, Freers J, Lachaud M, Mirabel M, Ferreira
Bea. Tropical endomyocardial fibrosis: natural history, challenges, and
perspectives.
Circulation
2016; 133: 2503–2515.
11. Tharakan JA. Electrocardiogram in endomyocardial fibrosis.
Ind Pacing
Electrophysiol J
2011;
11
(5): 129–1333.
12. Bogere H, Tucciarone A. Experts in landmark heart surgery at Mulago.
The Observer
5 June
2012.
13. Moraes F, Lapa C, Hazin S, Tenorio E, Gomes C, Moraes CR. Surgery
for endomyocardial fibrosis revisited.
Eur J Cardiothorac Surg
1999;
15
(3): 309–312.
14. Mocumbi AO, Sidi D, Vouhe P, Yacuob M. An innovative technique for
the relief of right ventricular trabecular cavity obliteration in endomyo-
cardial fibrosis.
J Thorac Cardiovasc Surg
2007;
134
: 1070–1072.