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Cardiac arrhythmia services in Africa from 2011 to 2018: the second report from the Pan African Society of Cardiology working group on cardiac arrhythmias and pacing
Aime Bonny Marcus Ngantcha Matthew Yuyun Kamilu M Karaye Wihan Scholtz Ahmed Suliman George Nel Yazid Aoudia Adama Kane Abdelhamid Moustaghfi
Aime Bonny
Marcus Ngantcha
Matthew Yuyun
Kamilu M Karaye
Wihan Scholtz
Ahmed Suliman
George Nel
Yazid Aoudia
Adama Kane
Abdelhamid Moustaghfi
Author
Aime Bonny
Marcus Ngantcha
Matthew Yuyun
Kamilu M Karaye
Wihan Scholtz
Ahmed Suliman
George Nel
Yazid Aoudia
Adama Kane
Abdelhamid Moustaghfi
Emmy Okello
Martin Houenassi
Arn Sonou
Ali Niakara
Yves Ray Lubenga
Anicet Adoubi
James A. Russell
Albertino Damasceno
Ali Ibrahim Toure
Abdoul Kane
Alioune Tabane
Mohammed Jeilan
Alassane Mbaye
Kemi Tibazarwa
Yousef Ben Ameur
Mamadou Diakite
Saad Subahi
Bundhoo Kaviraj
Mahmoud U Sani
Olujimi A Ajijola
Ashley Chin
Karen Sliwa-Hahnle
Marcus Ngantcha
Matthew Yuyun
Kamilu M Karaye
Wihan Scholtz
Ahmed Suliman
George Nel
Yazid Aoudia
Adama Kane
Abdelhamid Moustaghfi
Emmy Okello
Martin Houenassi
Arn Sonou
Ali Niakara
Yves Ray Lubenga
Anicet Adoubi
James A. Russell
Albertino Damasceno
Ali Ibrahim Toure
Abdoul Kane
Alioune Tabane
Mohammed Jeilan
Alassane Mbaye
Kemi Tibazarwa
Yousef Ben Ameur
Mamadou Diakite
Saad Subahi
Bundhoo Kaviraj
Mahmoud U Sani
Olujimi A Ajijola
Ashley Chin
Karen Sliwa-Hahnle
Abstract
Aims
Cardiac arrhythmia services are a neglected field of cardiology in Africa. To provide comprehensive contemporary information on the access and use of cardiac arrhythmia services in Africa.
Methods and results
Data on human resources, drug availability, cardiac implantable electronic devices (CIED), and ablation procedures were sought from member countries of Pan African Society of Cardiology. Data were received from 23 out of 31 countries. In most countries, healthcare services are primarily supported by household incomes. Vitamin K antagonists (VKAs), digoxin, and amiodarone were available in all countries, while the availability of other drugs varied widely. Non-VKA oral anticoagulants (NOACs) were unequally present in the African markets, while International Normalized Ratio monitoring was challenging. Four countries (18%) did not provide pacemaker implantations while, where available, the implantation and operator rates were 2.79 and 0.772 per million population, respectively. The countries with the highest pacemaker implantation rate/million population in descending order were Tunisia, Mauritius, South Africa, Algeria, and Morocco. Implantable cardioverter-defibrillator and cardiac resynchronization therapy (CRT) were performed in 15 (65%) and 12 (52%) countries, respectively. Reconditioned CIED were used in 5 (22%) countries. Electrophysiology was performed in 8 (35%) countries, but complex ablations only in countries from the Maghreb and South Africa. Marked variation in costs of CIED that severely mismatched the gross domestic product per capita was observed in Africa. From the first report, three countries have started performing simple ablations.
Conclusion
The access to arrhythmia treatments varied widely in Africa where hundreds of millions of people remain at risk of dying from heart block. Increased economic and human resources as well as infrastructures are the critical targets for improving arrhythmia services in Africa.
Keywords
cardiac arrhythmias, drug therapy, cardiac implantable electronic devices, electrophysiology, ablation, Africa, cardiac Arrhythmia Service
Date
2020
Type
Journal article
Journal
Europace
Book
Volume
22
Issue
3
Page Range
420-433
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled