Diseases of Lifestyle Awareness

Awareness day at Soweto hospital tests and educates Soweto residents on chronic illness – Wednesday, February 24, 2010

On Wednesday, February 24, 2010, a Chronic Diseases of Lifestyle Awareness Day was held at the Chris Hani Baragwanath Hospital Lapa under the auspices of the THRUST. The purpose of the day was to create awareness among public, patients and health professionals about the causes, treatment and prevention of chronic diseases of lifestyle. It was a huge success, with 80 patients, family, friends and members of the public attending the event. They received education on the causes, treatment and prevention of chronic diseases of lifestyle, as well as screening for risk factors such as, weight, height, body mass index, cholesterol, glucose and blood pressure.

“In low- to middle-income countries such as South Africa, where socio-economic conditions are improving and people are adopting more affluent lifestyles, hypertension and cardiovascular disease are likely to become more widespread in the population,” explained Prof Karen Sliwa-Hahnle, Senior Cardiologist and Director of the Soweto Cardiovascular Research Unit. “We recently held awareness days at taxi ranks in Soweto and found that 33% of the 1 600 black African people screened were obese and only 21% showed no major cardiovascular risk factors, which is very alarming, and so our need to host regular awareness days in Soweto.”

Dietician Sandra Pretorius advised the audience on the importance of maintaining a healthy body weight, the role of physical activity, and the importance of making regular visits to the clinic and regular monitoring of blood pressure, glucose and cholesterol. She also provided tips on how to follow a healthy daily diet.

Dietician Nokuthula Vilakati explained the importance of adopting healthy food choices in the home and passing these on to children and teenagers: “Young people today need to adopt a healthy lifestyle as they are the future. Many of the younger generation are influenced by television and through peer pressure have become consumed with dieting to look good, skipping meals and eating out regularly. This is not good – you need to watch your children and make sure you teach them the right way.”

A healthy lunch was enjoyed by everyone.

Click here for programme.

Socru presents at European Heart Failure meeting, Nice, France

The poster below formed part of the presentation. It is entitled "Vitamin C but not thiamine deficiency in black African patients with heart failure in South Africa: Identifying the need for nutritional intervention in the urban African setting".

Management of heart failure with limited resources

In the last 10-15 years, heart failure (HF) has emerged as a major health problem worldwide.

Since 2006, the Soweto Cardiovascular Research Unit, in conjunction with the Baker Cardiovascular Research Institute and the University of Queensland, has been involved in creating a large registry – the Heart of Soweto Study Registry.

In our study, very late presentation of more than 50% of the cases meant that the patients presented in heart failure. We found antecedents common to high-income countries and factors unique to South Africa that no doubt contributed to the unexpectedly large (and inherently preventable) volume of cases from this large urban region.

Numerous studies done by the unit described the characteristics of heart failure due to idiopathic and dilated cardiomyopathy and came up with suggestions for managing it.

We then identified a need to address the ‘epidemic of heart failure’ and started to prepare for a study to investigate the outcome with a multi-disciplinary heart failure management programme in 2008.

For the planning of this study we needed data from pilot studies. We examined the pattern of treatment adherence using a simple questionnaire in a cohort of HF patients from Soweto.

As in many other regions of the world, non-adherence to complex HF treatment was identified as a problem in Soweto and confirmed the need for a dedicated programme to optimise HF management and outcomes. Sandra Pretorius, dietician at the Soweto Cardiovascular Research Unit, presented those findings at the South African Heart Association meeting at Sun City in November 2007.

Consistent with data from Western developed countries, 20% of hospitalised patients with chronic forms of heart failure (CHF) at Chris Hani Baragwanath Hospital die within one year and 60% of survivors are readmitted to hospital within 18 months (unpublished data).

In developed countries, interest has been growing in dedicated CHF management programmes that provide individualised education, care and support to patients and families affected by this deadly and disabling syndrome. Such programmes have now become part of the gold-standard management of the syndrome, but there is no data to support their use in the developing world.

Hypothesis

A culturally specific, community-based management programme will improve health outcomes in patients with CHF living in Africa.

In order to examine the potential value of the type of CHF management that has successfully been developed and implemented in high-income countries, we decided to undertake a randomised controlled study of a multidisciplinary, community-based CHF management programme in Soweto, compared with the usual methods of care.

Core components of the study: The study will incorporate the key components of successful programmes of care in high-income countries:

1. Establish a comprehensive clinical and socio-demographic profile of the patient to determine the factors that are likely to increase or decrease the probability of future morbid or fatal events (as part of the Heart of Soweto Registry).
2. Prof Sliwa will give a lecture about heart failure and importance of compliance to the patient and family. Afterwards a ‘Living with Heart Failure in Soweto’ booklet will be given to the patient.
3. Sandra Pretorius will give a lecture about diet.
4. The patient or family can register for a cooking class with Sandra Pretorius.
5. The patient will be given a management diary (to document changes in weight and medication, for example).