title: A template for improved prevention and control of cardiovascular disease in sub-Saharan Africa.
abstract: Cardiovascular disease (CVD) is rapidly becoming an important public health problem in sub-Saharan Africa, yet the response so far is often minimal and inadequate. While there is, undoubtedly, a 'double burden of disease' (persisting infectious diseases co-existing with emerging non-communicable disease), this is hardly reflected in current health planning, possibly due to a limited appreciation of the changing pattern of CVD and CVD risk factor exposure. In a situation where there are also considerable budget constraints and well-established infectious disease priorities, it is difficult to implement effective interventions for prevention or treatment of CVD. Yet such planning is urgently needed and a template for a comprehensive programme, adaptable to local situations, is presented here. The first step is to raise awareness and create evidence-based commitment among policy-makers, which could lead to the establishment of a multi-sectoral CVD unit at national level. Programmes need to focus on prevention of modifiable risk factors at population level, involving a wide range of institutions and individuals. Recommended strategies include decentralizing the design and implementation of programmes, with appropriate standardized surveillance of major risk factors, all complemented by operational, epidemiological and basic research.
authors.affiliation: Medical Research Council Laboratories, Fajara, The Gambia. mvdsande@mrc.gm
authors.forename: M A
authors.initials: MA
authors.lastname: van der Sande
authors.forename: R L
authors.initials: RL
authors.lastname: Coleman
authors.forename: M F
authors.initials: MF
authors.lastname: Schim van der Loeff
authors.forename: K P
authors.initials: KP
authors.lastname: McAdam
authors.forename: O A
authors.initials: OA
authors.lastname: Nyan
authors.forename: T
authors.initials: T
authors.lastname: Thien
authors.forename: W M
authors.initials: WM
authors.lastname: Dolmans
authors.forename: G E
authors.initials: GE
authors.lastname: Walraven
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D004041:Dietary Fats / Q000008:administration & dosage; D015444:Exercise; D006285:Health Planning; D006801:Humans; D011050:Policy Making; D011159:Population Surveillance; D011314:Preventive Health Services; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012965:Sodium Chloride
chemical_list: D004041:Dietary Fats; D012965:Sodium Chloride