Lifestyle and Cardiovascular Risk Factors: Urban Population versus Rural Population in Sub-Saharan Africa

Cardiovascular diseases (CVD) are a major public health problem in Sub-Saharan Africa (SSA), as in the rest of the world, with increasingly increasing morbidity and mortality. We are presenting here, not the results of an epidemiological study, but rather a reflection on the problem of CVD and their risk factors (RFs) in SSA, taking into account the differences in lifestyle between rural and urban areas, the objective being to highlight the differences in the epidemiological profile trends relating to CVDs and their RFs between these two environments on the basis of existing data, to indicate some characteristic features of lifestyle in these two environments and to draw lessons from this in terms of the prospects for combating this new epidemic in this part of the world. We have indicated in this presentation that the prevalence of CVDs as well as that of their RFs show increasing trends in SSA due to new lifestyles linked in particular to urbanization and its numerous economic and social corollaries. However, data on their geographical and sociological distribution, especially in rural and urban areas, are still incomplete. The first existing epidemiological surveys seem to indicate that they are more firmly established in urban areas than in rural areas, probably linked to the difference in lifestyles between these two areas. We concluded by mentioning that it is necessary for SSA states to take the option of launching vast epidemiological and clinical research programs tending to make basic epidemiological data available, taking into account the specific geographic and sociological characteristics of African society. This knowledge, documented in the form of scientific evidence, would make it possible to consider with relevance and effectiveness measures to combat this new epidemic in developing countries

Stroke characterization in Sun Saharan Africa: Congolese population

International audienceBACKGROUND:Stroke is the second cause of death worldwide and over than 80% of deaths occurs in developing countries. However, its characteristics in the Democratic Republic of Congo (DRC) are poorly defined. This study aimed to describe the key features of stroke in a hospital population of Kinshasa in DRC and to assess the frequency of cardiovascular risk factors and their impact on target organs.METHODS:A descriptive study was carried out from three hospitals in Kinshasa between January and April 2013. Cardiovascular risk factors, clinical and biological data were collected during the study period. The study involved 166 patients aged 18years and over.RESULTS:The mean age of patients was 59.6±12.3years, the sex ratio for male of 1.9. Stroke was ischemic in 66% of cases. Hypertension was the most frequent cardiovascular risk factor (84.3%), followed by high blood cholesterol (45.2%).The etiologies of ischemic stroke (TOAST classification) were dominated by lacunas (38.5%) and embolic heart diseases (12.8%). The origin was unknown in 45.9% of cases. Coma was observed in 37% of patients on admission and was the main independent prognostic factor of mortality, which was 19.3%. Left ventricular hypertrophy and renal failure were found respectively in 64.7% and 34% of patients.CONCLUSION:This study found a growing increase of ischemic stroke in a society where hemorrhagic type used to be the most common, a high rate of hypertension, hypercholesterolemia and diabetes, indicative of a fast epidemiological transition

Clinical characteristics of COVID-19 patients hospitalized at Clinique Ngaliema, a public hospital in Kinshasa, in the Democratic Republic of Congo: A retrospective cohort study.

ObjectivesTo describe the clinical characteristics of patients infected with SARS-CoV-2 at Clinique Ngaliema, a public hospital, in Kinshasa, in the Democratic Republic of Congo (DRC).MethodsThis retrospective study analyzed medical records including socio-demographics, past medical history, clinical manifestation, comorbidities, laboratory data, treatment and disease outcome of 160 hospitalized COVID-19 patients, with confirmed result of SARS-CoV-2 viral infection.ResultsThe median age of patients was 54 years (IQR: 38-64), and there was no significant gender difference (51% of male). The most common comorbidities were hypertension (55 [34%]), diabetes (31 [19%]) and obesity (13 [8%]). Fever (93 [58%]), cough (92 [57%]), fatigue (87 [54%]), shortness of breath (72 [45%]) and myalgia (33 [21%]) were the most common symptoms, upon admission. Patients were categorized into mild (92 [57%]), moderate (19 [12%]) and severe (49 [31%]). Severe patients were older and were more likely to have comorbidities, compared to mild ones. The majority of patients (92% [147 of 160]) patients received hydroxychloroquine or chloroquine phosphate. Regression model revealed that older age, lower SpO2, higher heart rate and elevated AST at admission were all risk factors associated with in-hospital death. The prevalence of COVID-19 and malaria co-infection was 0.63% and 70 (44%) of all patients received antimalarial treatment before hospitalization.ConclusionOur findings indicated that the epidemiological and clinical feature of COVID-19 patients in Kinshasa are broadly similar to previous reports from other settings. Older age, lower SpO2, tachycardia, and elevated AST could help to identify patients at higher risk of death at an early stage of the illness. Plasmodium spp co-infection was not common in hospitalized COVID-19 patients