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Terseer adamu (Review)
They are silent killers. They cut
down Nigerians in their prime. They are the major causes of sudden deaths in
the country. Hypertension, diabetes, heart diseases or rather cardiovascular
diseases and their attendant consequences of stroke, heart attack, and kidney
failure are here to stay. CHUKWUMA MUANYA examines recent efforts towards
finding solutions to the menace.
AZUBUIKE Mba was a 40-year-old
banker with one of the old generation banks in Lagos. Azubuike stood at five
feet six inches, weighed 130 kilogrammes with waist circumference of 46
centimetres.
Azubuike was married for 12
years to Ngozi, also a banker, without children. He drank at least four bottles
of beer daily with sticks of cigarette to cap the habit.
He rarely exercised, but
moved from his air-conditioned house into his factory fitted air-conditioned
car then the office with equally cooler conditions, and back the same route
after work.
Azubuike slumped and died in
his office last month. Autopsy showed that he died of heart attack.
Azubuike represents
millions of Nigerians with high risk of developing complications of
non-communicable diseases (NCDs), chronic or rather degenerative diseases such
as heart attack, stroke, kidney failure, diabetic leg ulcer, limb amputations,
cancer, arthritis, among others.
According to the World Health
Organisation (WHO), an estimated 17.3 million people died from cardiovascular
diseases in 2008, representing 30 per cent of all global deaths. Of these
deaths, an estimated 7.3 million were due to coronary heart disease and 6.2
million were due to stroke.
However, medical experts,
assembled by Pfizer Nigeria & East Africa Region (Pfizer NEAR), have
identified hypertension, diabetes mellitus, hyperlipidaemia (high
fat/cholesterol level), cigarette smoking, obesity and sedentary living as
modifiable risk; while family history, age and gender as the non-modifiable
risk factors.
The team of medical experts
led by Consultant Nephrologist and Medical Director of Ibadan Hypertension
Clinic, Emeritus Professor Oladipo Akinkugbe, at the Cardiovascular Summit
organised recently by Pfizer Nigeria, Ghana and East Africa Region recommended
preventive strategies, which include control of high cholesterol levels and
high blood pressure through the modification of dietary habits and government‘s
support especially in the discouragement of western dietary habits through its
food and health regulatory agencies.
The aim of the sixth Pfizer
Cardiovascular Summit was improve awareness and management of common cardiovascular
risk factors such as raised blood pressure, raised cholesterol, obesity and
lifestyle by stimulating debate, discussion and education.
The Cardiovascular Summit
provided a forum for the advancement of medical knowledge and patient care. The
summit brought together international and local healthcare professionals to
deliberate on the new and emerging trends in the nature, diagnosis and
management of cardiovascular diseases in Nigeria.
Other members of the team
included Chief Consultant Nephrologist at the National Hospital, Abuja,
Professor Sunday Bwala, Chief of the Division of Endocrinology, Diabetes and
Metabolism at the University of Tennessee Health Science Centre, Memphis,
United States, Professor Sam Dagogo Jack, Medical Director/Chairman of the
Country Medical Council, CMC of Pfizer Worldwide Bio-Pharmaceutical Businesses,
Dr. Kodjo Soroh and Country Manager Pfizer Nigeria & East Africa Region,
Carl Engleman.
The team predicted an
imminent health tsunami in Nigeria if nothing was done urgently to address the
rising cases of NCDs and their complications.
To address the situation, the
medical experts called for a nationwide epidemiological mapping of NCDs such as
diabetes, hypertension, stroke, kidney failure, arthritis among others and national
programmes that would encourage physical activities like walking and sports.
They also called for
integration of the fight against NCDs into Vision 20:2020 with establishment of
set targets as well as timeframes in resemblance of the Millennium Development
Goals (MDGs).
Dagogo –Jack said: “The
ravages of hypertension and diabetes on the African continent can be seen daily
in the faces of our people who have suffered a stroke or heart failure or
developed kidney failure or lost a leg from amputation. These dreaded
consequences could be avoided by preventing and effectively managing diabetes
and hypertension. We have the knowledge to do both; the question is - do our
leaders and society have the awareness and will to harness resources to tame
the scourge of hypertension, diabetes, heart disease and stroke in our land?”
Engleman reiterated Pfizer’s
continuous commitment to education of physicians and the general public. “As
the world’s largest pharmaceutical company, Pfizer is committed to working in
partnership with healthcare providers, governments and stakeholders to improve
patient care. Cardiovascular disease is a major threat to public health in
Nigeria with significant impact on people and communities. The aim of the CV
Summit is improve awareness and management of common CV risk factors such as
raised blood pressure, raised cholesterol, obesity and lifestyle by stimulating
debate, discussion and education,” he said.
Soroh, said: “The
Cardiovascular Summit is part of Pfizer’s contribution to the advancement of
medical knowledge and patient care in the region. This further exemplifies the
commitment of Pfizer to world-class medical education, capacity building and
excellence in service to the Nigerian health sector. This platform will
provide healthcare practitioners an avenue to engage in robust discussions on
the latest trends in cardiovascular disease, its management, encourage use of
general treatment guidelines and recommendations for the management of patients
with cardiovascular disease.”
Akinkugbe said: “As night
follows day, the so called NCDs are going to set in. A wise country is going to
be proactive. It is already knocking at the door. It is going to be a health
tsunami if we don’t take concrete steps to prevent it, because the wherewithal
to prosecute medical remedy is often not there. The after events like kidney
failure is often beyond the reach of developing countries even the developed
ones are struggling. Therefore if we can put measures to prevent these
diseases, then we will be saving hundreds of millions….
“Adequate detection is
extremely important. It is not just going to the teaching hospital and checking
blood pressure but you have to go round the country, to the rural areas. That
was what we tried to do 20 years ago. We went round the country to see 20,000
persons selected from rural, semi urban areas and we had a map of hypertension,
diabetes. But the parameters today have changed. We use 160/95mmHg for
hypertension mapping and we found that four million Nigerians were hypertensive.
“The situation will certainly
be worse today because lifestyles of the average Nigeria have changed. We are
living more sedentary lifestyles and Western diets. Our own future must be in
our own hands and the preventive measures are quite cheap.
“The risk factors are the
same. One of the things we could do will be to set some targets even tie it to
Vision 20:2020 that by a certain date we will be able to reduce cardiovascular
diseases by a certain percentage. It is achievable and measurable.”
Akinkugbe said that detection
was critical and the country needed to update the epidemiological studies done
20 years ago. “We need to define the situation and do it through a proper
epidemiological study. Once you do that, then you begin to put in place
measures. Four million Nigerians as at that time were with hypertension. Any
measures to detect must be accompanied with measures to treat. Setting targets
is important because there is need to update in detection and get to definite
recommendations and the primary health centres ate the Local Government Areas
are the major engine rooms towards achieving this,” Akinkugbe said.
Bwala said: “We need to have
some king of national policy on the part of government. The Federal Ministry of
Health (FMOH) in fact came out with some kind of document in December last year
that is the National Programme for the Prevention of Stroke, but it never saw
the light of the day because of the way it was approached and it was earlier
said that the technology already existed with the GSM companies.
“In fact the driver that took
me to the airport gave a result he got from MTN in partnership with Nigerian
Society of Nephrology. Just a single page with his bio-data, his blood
pressures, sugar, lipids, family history of diabetes and high blood pressure
and I told him what to do and what not to do. That sort of partnership is
needed because the outreach of the GSM is incredible right into the nook and
crannies of this country. So we should exploit it to the fore because these things
are very easy to detect.
“We are trying to influence
the FMOH to come out with a policy and partner with the major multinational
Pfizer for instance. That way we can really address the problem holistically.
Screening the members of the National Assembly and Ministries Departments and
Agencies (MDAs) is just an individual thing, it doesn’t cover the society but
it is useful, because they are the policy makers and they are already scared
now that their members are dropping dead. So they are in a very receptive frame
of mind for proposals.
“I think we should make some
kind of submission to the National Assembly and the FMOH to include their
decision of broad coverage of the society. That way we can begin to address the
problem before the ‘Tsunami’.”
Jack added: “What you cannot
measure, you cannot tackle. There is need to make the LGAs operate as bureau of
health statistics where they can train people with template from medical
experts. There is also need to partner with industries because most of the
drugs are not manufactured locally and are very costly. The type of
hypertension we have here tend to be salt sensitive so we need to watch our
salt intake.”
Source: http://www.ngrguardiannews.com
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