141st APHA Annual Meeting and Exposition

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

288836
Use of low cost secondary prevention drugs in middle and low income countries in southern africa


Monday, November 4, 2013 : 1:10 p.m. - 1:30 p.m.

Annamarie Kruger, Ph D, Faculty of Health Sciences, North West University, Potchefstroom, South Africa
Thandi Rose Puoane, DrPH, School of Public Health, University of the Western Cape, Cape Town, South Africa
Jephat Chifamba, MPhil, Physiology Department, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
Ehimario Igumbor, Ph D, School of Public Health, University of the Western Cape, Bellville, South Africa
BACKGROUND: Hypertension is an important public health challenge worldwide. A systematic review on the evidence for hypertension in sub-Saharan Africa reported a prevalence of hypertension ranging between 13% and 48% with urban dwellers at higher risk than rural. Hypertension has long been an established risk factor for stroke and the timely diagnoses and treatment of hypertension is not debateable at all.

OBJECTIVE: To determine the use of secondary prevention drugs for cardiovascular disease in rural and urban communities from a middle income country (South Africa) and a low-income country (Zimbabwe).

METHODS: A group of 4585 volunteers from South Africa (3301urban and 1284 rural) and 1240 from Zimbabwe (458 Urban and 782 rural) with a mean age of 49,5 years participated in the Prospective Urban and Rural Epidemiology study. We assessed rates of previous cardiovascular disease and the use of effective secondary preventive drugs (anti-platelet drugs) and blood-pressure-lowering drugs with standardised questionnaires.

RESULTS: In South Africa a total of 2148 (47.4%) participants had hypertension and in Zimbabwe 614 (49.5%). In both countries the use of anti- platelet drugs was very low: South Africa 9.2% and in Zimbabwe 0.4%.

CONCLUSION: Stroke and cardiovascular disease in middle- and low-income countries are already placing a large burden on health services that are barely coping with infectious disease, HIV/AIDS, and diseases of poverty and violence. Systematic efforts are needed to understand why even inexpensive drugs are substantially underused in these countries.

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Discuss the importance of using secondary prevention drugs to prevent cardiovascular disease complications in patients with high risk

Keyword(s): Access and Services, Medicine

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was involved in data collection analysis and writing of the manuscript
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3229.0: Lessons learned about healthcare delivery and access from developing countries