Abstract
Cardiovascular disease (CVD) is the leading cause of mortality worldwide and an important cause of disability. In Africa, the burden of CVD is increasing rapidly and it is now a public health concern. Epidemiological data on diseases is scarce and fragmented on the continent. To review available data on the epidemiology and pattern of heart disease in Sudan. Data were obtained from the Sudan Household Survey (SHHS) 2006, annual health statistical reports of the Sudan Federal Ministry of Health, the STEPS survey of chronic disease risk factors in Sudan/Khartoum, and journal publications. The SHHS reported a prevalence of 2.5% for heart disease. Hypertensive heart disease (HHD), rheumatic heart disease (RHD), ischaemic heart disease (IHD) and cardiomyopathy constitute more than 80% of CVD in Sudan. Hypertension (HTN) had a prevalence of 20.1 and 20.4% in the SHHS and STEPS survey, respectively. There were poor control rates and a high prevalence of target-organ damage in the local studies. RHD prevalence data were available only for Khartoum state and the incidence has dropped from 3/1 000 people in the 1980s to 0.3% in 2003. There were no data on any other states. The coronary event rates in 1989 were 112/100 000 people, with a total mortality of 36/100 000. Prevalence rates of low physical activity, obesity, HTN, hypercholesterolaemia, diabetes and smoking were 86.8, 53.9, 23.6, 19.8, 19.2 and 12%, respectively, in the STEPS survey. Peripartum cardiomyopathy occurs at a rate of 1.5% of all deliveries. Congenital heart disease is prevalent in 0.2% of children. Heart diseases are an important cause of morbidity and mortality in Sudan. The tetrad of hypertension, RHD, IHD and cardiomyopathy constitute the bulk of CVD. Hypertension is prevalent, with poor control rates. A decline in rheumatic heart disease was seen in the capital state and no data were available on other parts of the country. No recent data on IHD were available. Peripartum cardiomyopathy and congenital heart disease occur at similar rates to those in other African countries.
Highlights
Cardiovascular disease (CVD) is the leading cause of mortality worldwide and an important cause of disability
Hypertensive heart disease (HHD), rheumatic heart disease (RHD), ischaemic heart disease (IHD) and cardiomyopathy constitute more than 80% of CVD in Sudan
We aim to review available epidemiological data on the burden of cardiovascular disease and its pattern in Sudan, as well as the prevalence of individual cardiac diseases, namely hypertensive, rheumatic and atherosclerotic heart diseases and their risk factors, cardiomyopathies, peripartum and dilated cardiomyopathy, and congenital heart diseases
Summary
Of 2006 was a questionnaire-based survey in all states of Sudan, organised by the Federal Ministry of Health and Ministry of Health of the Government of southern Sudan; 24 527 households and more than 55 000 Sudanese were surveyed. The self-reported prevalence of heart disease was 2.5% This figure remains low compared to developed countries.[12] Fig. 1 shows prevalence of cardiovascular disease compared to other non-communicable diseases in the SHHS. Cardiovascular disease has been consistently reported in the top 10 causes of hospital mortality, with malaria and acute respiratory infections as the first two causes. Such a significant contribution of cardiovascular disease to mortality is seen in other African countries.[13,14]
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