The prevalence, prevention, and treatment of cardiovascular diseases in Twelve African Countries (2014-2019): An analysis of the World Health Organisation STEPwise approach to chronic disease risk factor surveillance.

The overall prevalence of cardiovascular disease (CVD) across twelve African countries was 5%.

• Analysis was based on 60,294 individuals using WHO STEPwise Approach to Surveillance (STEPS) data from 2014 to 2019.
• CVD was defined as a self-reported history of heart attack, angina, or stroke.
• Data came from 12 African countries with weighted percentages and odds ratios computed using R software.
• Logistic regression models were fitted to select predictor variables for CVD prevalence, prevention, and treatment binary endpoints.

CVD prevalence was higher in older individuals, females, individuals with hypertension, smokers, people with high salt intake, and varied by country.

• These factors were identified as significant predictors through logistic regression models.
• Hypertension status, sex, age, and country were among the key predictor variables for CVD prevalence.
• The analysis used weighted odds ratios (OR) and corresponding 95% confidence intervals (95%CI).

Only 11% of individuals at high risk of CVD but without a history of the disease received CVD prevention treatment.

• The high-risk group was defined as individuals aged 40 years or older without a history of CVD.
• There were 23,630 individuals in this high-risk group across the twelve countries.
• This indicates a substantial gap in primary prevention efforts across the studied African countries.

Among persons with CVD, only 22% received treatment and counselling for CVD.

• The analysis of CVD treatment was based on 2,895 persons with CVDs.
• Of those receiving treatment: 34% (n=215) received aspirin, 32% (n=202) received counselling for CVD risk factors, 11% (n=66) received statins, and 24% (n=148) received both statins and aspirin.
• Uptake of CVD treatment varied by hypertension status, sex, age, and country.

CVD treatment and prevention uptake varied significantly by hypertension status, sex, age, and country.

• These variables were identified as significant predictors in logistic regression models for both CVD prevention and CVD treatment endpoints.
• Variation by country suggests differential healthcare access and capacity across the twelve African nations studied.
• The study covered data from 12 African countries between 2014 and 2019.

Concerted efforts are needed to accelerate diagnosis and expand treatment for CVDs in Africa to curtail untimely deaths.

• CVDs are responsible for nearly a third of deaths globally, providing context for the public health importance of the findings.
• The sub-optimal treatment uptake (22% of CVD patients receiving treatment and counselling) underscores the need for health system strengthening.
• Only 11% of high-risk individuals received prevention treatment, highlighting a gap in primary prevention as well as secondary treatment.