64 / 70
CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 5, September/October 2019
306
AFRICA
Physical activity
In 2010, the percentage of 11–17-year-old adolescents who
were insufficiently active (less than 60 minutes of moderate- to
vigorous-intensity physical activity daily) was 91.9% (global data
= 80.7%).
4
The age-standardised estimate for adults who were
insufficiently active (less than 150 minutes of moderate-intensity
physical activity per week, or less than 75 minutes of vigorous-
intensity physical activity per week) was 14.1% (global data =
27.5%) (Table 1).
3
Overweight and obesity
In 2018, the prevalence of overweight [body mass index (BMI)
≥
25–
<
30 kg/m
2
] and obesity (BMI
≥
30 kg/m
2
) in adults 25 years
and older was 28.2 and 10.3%, respectively.
3
Compared to global
data, both these indicators are somewhat lower than that of
38.9% for overweight and 13.1% for obesity (Table 1).
Diabetes
The percentage of the population defined with fasting glucose
levels
≥
7.0 mmol/l or on medication for raised blood glucose
(age standardised) in 2018 was 5.1% for men and 7% for women.
3
In 2017, the prevalence of age-adjusted (18–99 years) diabetes
was 15.7%, which is much higher than that of Africa or the world
(Table 1).
5
Part C: Clinical practice and guidelines
Health system capacity
The country had an average of 3.14 physicians and 11.57 nurses
per 10 000 of the population in 2008 and 2014, respectively. For
every 10 000 people, there were eight hospital beds in 2013.
4
Locally relevant clinical tools to assess CVD risk have been
adopted since 2015.
6
Sudan was one of the lower-middle-income
countries to participate in the REMEDY study that reported a
hospital-based registry for RHD.
7
Locally relevant (national or sub-national) clinical guidelines
for the management of acute rheumatic fever (ARF) and RHD
are also available.
8
No national guidelines for the treatment of
tobacco dependence or for the detection and management of AF
and pharyngitis have been set up. In 2011, the Federal Ministry
of Health (FMOH) NCD directorate, in collaboration with
the World Health Organisation (WHO), developed the Sudan
diabetes mellitus guidelines.
9
Essential medicines and interventions
ACE inhibitors, aspirin,
β
-blockers, statins, insulin, warfarin
and clopidogrel are included in the list of essential medicines
in primary-care facilities in the public health sector. However,
metformin is not included.
4
Table 1. Cardiovascular disease indicators for Sudan
Indicators
Male
Female
Total
Year
Status of national CVD epidemic
Premature CVD mortality (age 30–70 years) (% of deaths)
–
–
10
2012
Total CVD mortality (% of deaths)
32.9
33.1
33 (31.8)* 2017
Total RHD mortality (% of deaths)
0.3
0.5
0.4 (0.5)* 2017
Percentage of DALYs attributable to CVD (%)
12.7
11.7
12.3 (14.7)* 2017
Percentage of AF and arterial flutter (%)
0.2
0.1
0.1 (0.5)* 2017
Prevalence of RHD (%)
0.6
0.7
0.6 (0.5)* 2017
Tobacco and alcohol
Prevalence of adult tobacco use (15+ years old) (%)
27.9 (36.1)* 0.8 (6.8)*
–
2018
Prevalence of youth (13–15-year-olds) tobacco use (%)
9.5
4.3
2009
Estimated direct (e.g. healthcare related) cost of tobacco use in your population (in current US$)
5.91
2018
Proportion of premature CVD mortality attributable to tobacco (%)
–
–
1 (10)*
2012
Recorded alcohol consumption per capita (15+ years) (in litres of pure alcohol) (three-year average)
0
2015–17
Raised blood pressure and cholesterol
Percentage of population with raised blood pressure (SBP
≥
140 or DBP
≥
90 mmHg) (%)
31 (24.1)* 32.1 (20.1)*
–
2018
Percentage of population with raised total cholesterol (
≥
5.0 mmol/l) (%)
8.8
19.5
13.6 (38.9)* 2018
Percentage of DALYs attributable to hypertension (%)
7.6
7.4
7.5 (8.7)* 2017
Mortality caused by hypertensive heart disease (% of deaths)
1.7
2.8
2.2 (1.7)* 2017
Physical activity
Percentage of adolescents (ages 11–17) who are insufficiently active (
<
60 min of moderate- to vigorous-intensi-
ty physical activity daily) (%)
91.2
92.3
91.9 (80.7)* 2010
Percentage of adults (age-standardised estimate) who are insufficiently active (
<
150 minutes of moderate-inten-
sity physical activity per week, or
<
75 minutes of vigorous-intensity physical activity per week) (%)
11.4
17.3
14.1 (27.5)* 2018
Overweight and obesity
Percentage of adults who are overweight (BMI
≥
25–
<
30 kg/m
2
) (%)
22.6
35.6
28.2 (38.9)* 2018
Prevalence of obesity (BMI
≥
30 kg/m
2
) (%)
6.7
14.9
10.3 (13.1)* 2018
Diabetes
Percentage of defined population with fasting glucose
≥
126 mg/dl (7.0 mmol/l) or on medication for raised
blood glucose (age standardised) (%)
5.1 (9)*
7 (8)*
–
2018
Prevalence of diabetes (ages 20–79) (%)
–
–
15.7 (8.6)** 2017
*WHO Global data.
4
**IDF Diabetes Atlas.
5