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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 31, No 2, March/April 2020
AFRICA
103
PASCAR and WHF Cardiovascular Diseases Scorecard
project
Anastase Dzudie, Jean M Fourie, Wihan Scholtz, Oana Scarlatescu, George Nel, Samuel Kingue
Abstract
Data collected by PASCAR for the World Heart Federation’s
Cardiovascular Diseases Scorecard project in Africa are
presented. We summarise the strengths, threats, weaknesses
and priorities identified from the collected data, which need
to be considered in conjunction with the associated sections
in the accompanying infographic. Data sets that were used
include open-source data from the World Bank, World Health
Organization and government publications.
Cardiovasc J Afr
2020;
31
: 103–110
DOI: 10-5830-CVJA-2020-015
Onbehalf of theWorldHeartFederation (WHF), thePan-African
Society of Cardiology (PASCAR) co-ordinated data collection
and reporting for the country-level Cardiovascular Diseases
(CVD) Scorecard to be used in Africa.
1
The objective of the
scorecard is to create a clear picture of the current state of
CVD prevention, control and management, along with related
non-communicable diseases (NCD) in 12 African countries.
The Cameroon Cardiac Society, a member of PASCAR and the
WHF, along with Professors Dzudie (scientific secretary) and
Kingue (president), assisted in collating and verifying these data.
Part A: Demographics
According to the World Bank (2018), Cameroon is a lower-
middle-income country with 44% of its people living in rural
areas. In 2014, 23.8% of the population were living below the
US$1.9-a-day ratio.
2
Life expectancy at birth in 2018 was 58
and 60 years for men and women, respectively. The general
government health expenditure was 0.6% of the gross domestic
product (GDP) in 2017, while the country GDP per capita was
US$1 533.7 in 2018.
2
Part B: National cardiovascular disease epidemic
National response to CVD and NCD
In 2012, Cameroon’s premature death rate attributable to CVD
(age 30–70 years) was similar to its neighbouring country,
Nigeria, at 12%.
3
In 2017, the age-standardised total CVD death
rate was high at 11.85%, although much lower than the 31.8%
for the global burden of disease (GBD) data.
4
The percentage of
disability-adjusted life years (DALYs) resulting from CVD for
men and women was 5.0 and 5.03%, respectively, which is lower
than the GBD at 14.66% for both genders. The prevalence of
atrial fibrillation (AF) and atrial flutter was 0.13%, while that of
rheumatic heart disease (RHD) was 0.78%, which is higher when
compared to the GBD RHD prevalence of 0.53%. The total
RHD mortality rate was 0.02% of all deaths, which is lower than
the GBD data (0.51%) (Table 1).
4
Tobacco and alcohol
The prevalence of tobacco use in adult men and women (15+
years old) was 43.8 and 0.9%, respectively.
5
Comparative Global
Health Observatory (GHO) data are 36.1% for men and 6.8% for
women.
5
No data are available for adolescent tobacco use (13–15
years old) and the estimated annual direct cost of tobacco use is
also not known. The premature CVD mortality rate attributable
to tobacco is 2% of the total mortality rate, which is much lower
than that of the global 10%.
6
The three-year (2015–17) average
recorded alcohol consumption per capita (15+ years) was 6.5
litres (Table 1).
5
Raised blood pressure and cholesterol
In 2015, 31.3% of men and 30.8% of women had raised blood
pressure (BP) levels (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90
mmHg), which is higher than the GHO level of 24.1 and 20.1%
for men and women, respectively, and Africa’s 27.4% for both.
5
In a screening study, only 31.7% of participants were found
to be aware of their hypertension status, 59.9% of them were
on treatment and of these, 24.6% had controlled BP levels.
7
In
another study, Kingue
et al
. found a prevalence of 29.7%, with
14.1% awareness.
8
The percentage of individuals with raised total
cholesterol levels (
≥
5.0 mmol/l or currently being on medication
for raised cholesterol) was 26% compared to GHO data (38.9%).
5
Department of Internal Medicine, Yaoundé Faculty of
Medicine and Biomedical Sciences, Yaoundé, Cameroon
Anastase Dzudie, MD
Samuel Kingue, MD
Pan-African Society of Cardiology, Cape Town, South
Africa
Jean M Fourie
Wihan Scholtz,
wihan@medsoc.co.zaGeorge Nel
World Heart Federation, Geneva, Switzerland
Oana Scarlatescu
Cameroon Country Report