Health

Is Kenya sitting on ticking heart attack time bomb?

cardio

The burden of non-communicable diseases is shifting to poor countries as death rates in developed.

Heart disease used to be prevalent in developed countries, but is now spreading fast to developing nations like Kenya.

And for most of these countries, heart attacks will hit like a tornado, catching governments unawares as they concentrate their resources on fighting malaria, Aids, child mortality, while neglecting non-communicable diseases.

The World Health Organisation has raised the alarm, stating that 60 per of the global burden of heart disease now lies in developing nations. Cardiovascular diseases claim 17.3 million deaths every year and account for one in ten deaths in Africa.

Kenya lacks accurate statistics on the real picture of heart disease among her citizens, but in South Africa someone suffers from a heart attack or chest pain every seven minutes, totalling to more than 74,000 incidents per year.

In 2010, over 50 people suffered fatal heart attacks in South Africa daily or 20,500 deaths, according to a report by Dr Mohamed Jeilan, an interventional cardiologist.

‘‘There is a rising prevalence of heart attack in Kenya,’’ said Dr Jeilan, who is the head of cardiology at Aga Khan University Hospital in Nairobi.

The prevalence of cardiovascular diseases is attributed to many risk factors such as hypertension, smoking, diabetes, obesity and an ageing population, he said.

Growing incomes in Kenya have ushered in an era of sedentary lifestyles and diets laced with fats, which contribute to the bulging waist lines. This has triggered a rise in obesity, high blood pressure, which are major causes of heart attacks.

And as more people increase their belt sizes, are we ready to muzzle the silent killer?

Kenya lacks adequate and well equipped emergency 24-hour heart attack centres, has only a few cardiologists specialised in treating heart attacks, while most counties have no ambulances.

However, a private hospital like Aga Khan has set up a 24-hour heart attack centre where patients are attended to by a team of heart specialists. ‘‘This is one of its kind in the region,” Dr Jeilan said.

The public also needs to be enlightened about the disease. A study shows that Kenyans take up to 12 -17 hours to seek medical help for worse heart attacks compared to an educated population in UK that takes less than 60 minutes to call 911. For mild ones, Kenyans take from 29 to 52 hours to go to hospital.

Children

Readiness for maternity and non-communicable services like heart attack and cancer — two critical priority areas for the sector—are too low in most counties, a government report on a comprehensive mapping of health services, capacity of service provision, sector investment and readiness to provide services by county (Saram) 2013 notes.

While the government has made major strides and has been investing in children vaccination with 85 per cent of facilities having vaccines, only 25 per cent of the country’s health facilities stock essential medicines for heart diseases, stroke, cancer, diabetes and chronic respiratory diseases.

The proportion of health facilities stocking insulin injection for diabetes, which increases the risk of heart attack, was only 13 per cent and Aspirin 300mg tablets for heart attacks were 55 per cent.

Major

Hypertension is a major risk factor for cardiovascular disease and indicates an increased risk for heart attack, heart failure, stroke or other complications.

Africa is home to the highest prevalence of people with high blood pressure, according to a status report on hypertension in the continent. In 2000, there were approximately 80 million adults with hypertension in sub-Saharan Africa.

Current epidemiological data suggest that this figure will rise to 150 million by 2025.

“Cardiovascular disease is rapidly rising in Africa and hypertension is one of the main risk factors. In Kenya alone, over 40 per cent of adults have high blood pressure and it is vital that we address this growing problem early by increasing awareness, treatment and control rates,’’ Prof Elijah Ogola, Kenya vice-president (East) for the Pan African Society of Cardiology, states.

A national initiative, Healthy Heart Africa, was recently launched in Nairobi to support local health systems by increasing awareness about the symptoms and risks of hypertension while offering education, screening, treatment and control.

The campaign initiative incorporates many partners including the Ministry of Health, Astra Zeneca, AMPATH, Amref Kenya, the Christian Health Association of Kenya, Jhpiego, Population Services Kenya, Mission for Essential Drugs and Supplies and Abt Associates.

“Recognising a significant unmet medical need, we have been working closely with governments, health experts and community organisations to design a programme that can have a real and lasting impact on the identification, treatment and prevention of hypertension in Africa—one that offers education and care as well as access to affordable medicines,” said Mark Mallon, executive vice president, International at AstraZeneca during the launch of Healthy Heart Africa programme.

So what have developed countries done right in increasing survival rates? A few years ago, UK started educating its population, streamlined ambulance services and hospitals, and was successfully in reducing heart attack deaths.

‘‘Unless current trends are halted or reversed, over a billion people will die from cardiovascular disease. The large majority will be in developing countries and much of the life years will be lost in middle age,” notes a University of Auckland in New Zealand report.