title: Cardiac critical care in resource-limited environments: lessons from Tanzania.
abstract: The concept of cardiac critical care is emerging as a tool in the management of cardiovascular diseases in many Sub-Saharan African countries. The region is undergoing significant epidemiological transition. There remains a significant burden of infectious and nutritional disease, but cardiovascular disease, notably hypertension and coronary artery disease, as well as other noncommunicable diseases (NCD) are emerging rapidly, placing a double burden on existing healthcare systems. Within this complex, heterogeneous, and changing epidemiologic setting, efforts to diagnose and treat cardiovascular diseases have increased. As more patients are diagnosed with acute cardiac conditions, the number requiring management in a cardiac critical care unit is also increasing. In this review, using the Tanzanian experience, we attempt to chronicle the appearance of cardiac critical care services and the many challenges to their implementation in a resource-limited environment.
authors: Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors: Pilly
authors: P
authors: Chillo
authors: Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Global Health Service Partnership (United States Peace Corps-Seed Global Health), Washington, DC, and Boston, MA, USA. Electronic address: humphreysteveh@gmail.com.
authors: Stephen H
authors: SH
authors: Humphrey
authors: Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors: John
authors: J
authors: Meda
authors: Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Center for Global Health, Massachusetts General Hospital, Boston, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Seed Global Health, Boston, MA, USA.
authors: Vanessa B
authors: VB
authors: Kerry
mesh_terms: D003422:Critical Care / Q000639:trends; D003695:Delivery of Health Care; D004501:Education, Medical; D005544:Forecasting; D006295:Health Resources; D006331:Heart Diseases / Q000628:therapy*; D006801:Humans; D013636:Tanzania; D000078329:Workforce