P1073Epidemiology of sudden cardiac death in sub-saharan africa: a population-based cohort survey in cameroon

AbstractPurposeThe Chikwawa lung health cohort was established in rural Malawi in 2014 to prospectively determine the prevalence and causes of lung disease amongst the general population of adults living in a low-income rural setting in Sub-Saharan Africa.ParticipantsA total of 1481 participants were randomly identified and recruited in 2014 for the baseline study. We collected data on demographic, socio-economic status, respiratory symptoms and potentially relevant exposures such as smoking, household fuels, environmental exposures, occupational history/exposures, dietary intake, healthcare utilization, cost (medication, outpatient visits and inpatient admissions) and productivity losses. Spirometry was performed to assess lung function. At baseline, 56.9% of the participants were female, a mean age of 43.8 (SD:17.8) and mean body mass index (BMI) of 21.6 Kg/m2 (SD: 3.46)Findings to dateCurrently, two studies have been published. The first reported the prevalence of chronic respiratory symptoms (13.6%, 95% confidence interval [CI], 11.9 – 15.4), spirometric obstruction (8.7%, 95% CI, 7.0 – 10.7), and spirometric restriction (34.8%, 95% CI, 31.7 – 38.0). The second reported annual decline in forced expiratory volume in one second [FEV1] of 30.9mL/year (95% CI: 21.6 to 40.1) and forced vital capacity [FVC] by 38.3 mL/year (95% CI: 28.5 to 48.1).Future plansThe ongoing current phase of follow-up will determine the annual rate of decline in lung function as measured through spirometry, and relate this to morbidity, mortality and economic cost of airflow obstruction and restriction. Population-based mathematical models will be developed driven by the empirical data from the cohort and national population data for Malawi to assess the effects of interventions and programmes to address the lung burden in Malawi. The present follow-up study started in 2019.Strengths and limitations of this studyThis is an original cohort study comprising adults randomly identified in a low-income Sub-Saharan African Setting.The repeated follow up of the cohort has included objective measures of lung function.The cohort has had high rates of case ascertainment that include verbal autopsies.The study will include an analysis of the health economic consequences of rate of change of lung function and health economic modelling of impact of lung diseases and potential interventions that could be adopted.A main limitation of our study is the systematic bias may be introduced through the self-selection of the participants who agreed to take part in the study to date and the migration of individuals from Chikwawa.

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Abstract 5017: An Insertion/Deletion Polyporphism in α 2 -Adrenergic Receptor Gene is a Novel Genetic Risk Factors Sudden Cardiac Death

Circulation ◽

10.1161/circ.118.suppl_18.s_1132-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Jari Laukkanen

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Sudden Cardiac Death ◽

Genetic Risk ◽

Cardiac Death ◽

Cox Model ◽

Receptor Gene ◽

Hdl Cholesterol ◽

Population Based ◽

Coronary Risk Factors

α 2B -adrenoceptors mediate contraction of vascular smooth muscle and induce coronary vasoconstriction in humans. A variant of the human α 2B -adrenoceptor gene that encodes a D of three residues in an intracellular acidic motif has been shown to confer decreased receptor desensitization. This receptor variant could, therefore, be involved in cardiovascular diseases associated with enhanced vasoconstriction. Our aim was to study whether an insertion/deletion (I/D) polymorphism in the α 2B -adrenoceptor gene is associated with the risk for sudden cardiac death. This study was part of a prospective population-based study investigating risk factors for cardiovascular diseases in a cohort of middle-aged men from eastern Finland. The study is based on 1606 men 42 to 60 years of age followed for an average time of 17 years. In this study population, 338 men (21%) had the D/D genotype; 467 (29 %) had the I/I genotype, and 801 (50%) had a heterozygous genotype. There were 76 sudden cardiac deaths during follow-up. In a Cox model adjusting for other coronary risk factors (age, systolic blood pressure, smoking, diabetes, serum LDL and HDL cholesterol, body mass index and exercise-induced myocardial ischemia), men with the D/D or I/D genotype had 1.95 time (95% confidence interval, 1.07 to 3.55, P = 0.029) higher risk to experience sudden cardiac death (20 events for D/D genotype, 13 events for I/I genotype and 43 events for I/D genotype) compared with men carrying the I/I genotype. The α 2B -adrenoceptor genotype was associated with coronary heart disease death but not with hypertension. The D/D and I/D genotypes of the α 2B -adrenoceptor are novel genetic risk predictors for sudden cardiac death.

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Neurocysticercosis – A Journey from Pre-independence to Modern India

Annals of the National Academy of Medical Sciences (India) ◽

10.1055/s-0040-1712609 ◽

2016 ◽

Vol 52 (02) ◽

pp. 076-099

Author(s):

Gagandeep Singh ◽

Monika Singla

Keyword(s):

Indian Subcontinent ◽

Taenia Solium ◽

Population Based ◽

Sub Saharan Africa ◽

Ct Scans ◽

Common Finding ◽

Cns Involvement ◽

High Prevalence ◽

Endemic Areas ◽

Sub Saharan

ABSTRACTNeurocysticercosis (NCC) is infestation of the human brain by the larva of worm, Taenia solium and is the most prevalent central nervous system (CNS) helminthiasis. The disease is widespread in tropical and subtropical regions of the world, including the Indian subcontinent, China, Sub-Saharan Africa, Central and South America and contributes substantially to the burden of epilepsy in these areas(1) . CNS involvement is seen in 60-90% of systemic cysticercosis. About 2.5 million people worldwide are infected with T. solium, and antibodies to T. solium are seen in up to 25% of people in endemic areas(1-3) . A higher prevalence of epilepsy and seizures in endemic countries is partly because of a high prevalence of cysticercosis in these regions. Seizures are thought to be caused by NCC in as many as 30% of adult patients and in 51% of children in population based endemic regions (2) . About 12% of admissions to neurological services in endemic regions are attributed to NCC and nearly half a million deaths occurring annually worldwide can be attributed directly or indirectly to NCC (Bern et al.). Punctate calcific foci on CT scan are a very common finding in asymptomatic people residing in endemic areas, found in 14-20 % of CT scans. Both seizures and positive cysticercus serology are associated with the detection of cysticerci on CT scans. Seroprevalence using a recently developed CDC- based enzyme-linked immunotransfer blot (EITB) assay is estimated at 8-12% in Latin America and 4.9-24% in Africa and South-East Asia. It is estimated that 20 million people harbour neurocysticercosis worldwide(1) .

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Adherence to Iron Supplementation in 22 Sub-Saharan African Countries and Associated Factors among Pregnant Women: A Large Population-Based Study

Current Developments in Nutrition ◽

10.1093/cdn/nzz120 ◽

2019 ◽

Vol 3 (12) ◽

Cited By ~ 5

Author(s):

Djibril M Ba ◽

Paddy Ssentongo ◽

Kristen H Kjerulff ◽

Muzi Na ◽

Guodong Liu ◽

...

Keyword(s):

Pregnant Women ◽

Iron Supplementation ◽

Population Based ◽

Sub Saharan Africa ◽

Deficiency Anemia ◽

Demographic And Health Surveys ◽

Factors Associated ◽

Sub Saharan ◽

Ssa Countries ◽

Antenatal Visits

ABSTRACT Background Iron deficiency anemia during pregnancy is a significant public health problem in sub-Saharan Africa (SSA) and is associated with serious adverse health outcomes. Although it is recommended that all women receive iron supplementation during pregnancy, little research has been conducted to measure overall compliance with this recommendation or variation across SSA countries. Objectives To assess prevalence and sociodemographic-economic factors associated with adherence to iron supplementation among pregnant women in SSA. Methods This was a weighted population-based cross-sectional study of 148,528 pregnant women aged 15–49 y in 22 SSA countries that participated in the Demographic and Health Surveys (DHS) in 2013–2018 and measured iron supplementation during pregnancy. Adherence to iron supplementation was defined as using iron supplementation for ≥90 d during pregnancy of the most recent birth. Results The overall prevalence of adherence to ≥90 d of iron supplementation during pregnancy was 28.7%, ranging from 1.4% in Burundi to 73.0% in Senegal. Factors associated with adherence included receiving ≥4 antenatal care visits [adjusted Prevalence Ratio (aPR): 25.73; 95% CI: 22.36, 29.60] compared with no antenatal visits; secondary or higher education (aPR: 1.17; 95% CI: 1.14, 1.19) compared with no education; wealthy (aPR: 1.13; 95% CI: 1.10, 1.16) compared with poor; and older women aged 35–49 y (aPR: 1.07; 95% CI: 1.05, 1.10) compared with younger women aged 15–24 y. Conclusions Adherence to iron supplementation during pregnancy in SSA is low and varies substantially across countries and in relation to factors such as number of antenatal visits, education, and level of family wealth. These results underscore the need for increased efforts to improve the uptake of iron supplementation for pregnant women in SSA.

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