Lifestyle, cardiovascular risk knowledge and patient counselling among selected sub-Saharan African family physicians and trainees

Background: Cardiovascular disease (CVD)-related deaths in sub-Saharan Africa (SSA) are on the rise, and primary care physicians could facilitate the reversal of this trend through treatment and prevention strategies. Aim: The aim of this study was to determine the relationship between physician lifestyle practices, CVD prevention knowledge and patient CVD counselling practices among family physicians (FPs) and family medicine (FM) trainees affiliated to FM colleges and organisations in SSA. Setting: FPs and FM trainees affiliated to FM colleges and organisations in Anglophone SSA. Methods: A web-based cross-sectional analytical study was conducted using validated, self-administered questionnaires. Following collation of responses, the relationship between the participants' CVD prevention knowledge, lifestyle practices and CVD counselling rates was assessed.Results: Of the 174 participants (53% response rate), 83% were married, 51% were females and the mean age was 39.2 (standard deviation [SD] 7.6) years. Most of the participants responded accurately to the CVD prevention knowledge items, but few had accurate responses on prioritising care by 10-year risk. Most participants had less than optimal lifestyle practices except for smoking, vegetable or fruit ingestion and sleep habits. Most participants (65%) usually counselled patients on nutrition, but less frequently on weight management, exercise, smoking and alcohol. The region of practice and physicians with poor lifestyle were predictive of patient counselling rates.Conclusion: Training on patient counselling and self-awareness for CVD prevention may influence patient counselling practice. Promoting quality training on patient counselling among FPs as well as a healthy self-awareness for CVD prevention is thus needed. The complex relationship between physician lifestyle and patient counselling warrants further study

Risk Assessment in the Prevention of Cardiovascular Disease in Low- Resource Settings : Lessons for Practitioners in Nigeria

BACKGROUND:Cardiovascular disease prevalence is increasing in low and middle-income countries; which bear around 75-80% of the global burden. Total cardiovascular disease risk assessment is key to prevention. METHODS.A search of studies published between 1990 and 2013 was conducted. Medline database; PubMed and World Health organization report sheets were used. RESULTS.The ideal risk prediction tool is one that is derived from the population in which it is to be applied. In the absence of national population based cohort studies in sub- Saharan African countries like Nigeria. there is no tool that is used consistently. Regardless of which one is adopted by national guidelines; routine consistent use is advocated by various CVD prevention guidelines. CONCLUSIONS In low-resource settings; the consistent use of simple tools like the WHO charts is recommended as the benefit of a standard approach to screening outweighs the risk of missing an opportunity to prevent CVD

Cardiovascular disease prevention in Ghana: feasibility of a faith-based organizational approach

Objective To examine the feasibility of using community health workers (CHWs) to implement cardiovascular disease (CVD) prevention programmes within faith-based organizations in Accra; Ghana. Methods Faith-based organization capacity; human resources; health programme sustainability/barriers and community members' knowledge were evaluated. Data on these aspects were gathered through a mixed method design consisting of in-depth interviews and focus groups with 25 church leaders and health committee members from five churches; and of a survey of 167 adult congregants from two churches. Findings The delivery of a CVD prevention programme in faith-based organizations by CHWs is feasible. Many faith-based organizations already provide health programmes for congregants and involve non-health professionals in their health-care activities; and most congregants have a basic knowledge of CVD. Yet despite the feasibility of the proposed approach to CVD prevention through faith-based organizations; sociocultural and health-care barriers such as poverty; limited human and economic resources and limited access to health care could hinder programme implementation. Conclusion The barriers to implementation identified in this study need to be considered when defining CVD prevention programme policy and planning

The Burden of Cardiovascular Disease in Sub-Saharan Africa

"The burden of cardiovascular disease (CVD) in Africa is growing and changing in nature. From the predominance of rheumatic heart disease and cardiomyopathies 50 years ago to hypertensive heart disease and haemorrhagic stroke in the past 25 years. Albeit at low prevalence; an increase in incidence of ischaemic heart disease is now being seen; particularly in urban areas. These changes in the extent and nature of CVD are thought to be the result of the so-called ""epidemiological transition"". The challenge for health promotion and prevention is to accelerate the course of that transition and blunt its magnitude in order to avoid the massive epidemics of CVD that were seen in Europe and the USA in the mid-twentieth century."

The impact of cigarettes smoking on cardiovascular health

The cost of mounting health education programmes to warn people about the dangers of smoking is far below the expensive resources necessary to undertake major palliative operations such as coronary artery bypass grafting and heart-lung transplantation; not to mention the man-power loss due to the smoking-related morbidity and mortality. It means that prevention is better than treatment