Researchers get to heart of African disease

Aberdeen researchers and colleagues in Botswana are to lead a major new initiative in sub Saharan Africa to try to prevent cardiovascular diseases (CVD) - a rapidly growing threat that is estimated to claim at least one million lives in the region each year.

CVD - which includes heart disease and stroke - is the world's leading killer. It accounts for about 17 million deaths across the world each year - almost half of all adult deaths.

While the incidence of CVD is decreasing in Western Europe and Northern America - reflecting national public health and policy efforts to tackle the disease, rates of CVD in developing countries are rising sharply. By 2020 it is expected that 80% of all CVD deaths will occur in developing countries. This is of particular concern in sub-Saharan Africa where, of all non-infectious diseases, CVD is already the leading cause of death.

Earlier this year, a seminar organised by the University of Aberdeen, Scotland was held in the capital of Botswana to discuss ways of tackling CVD in the region. It brought together local and international experts in medical research and policy, including representatives from the Government of Botswana and the World Health Organization.

The seminar unanimously agreed that large-scale high-quality research projects investigating causes of CVD in sub-Saharan Africa are desperately needed.

Now, as a result, a major new research project, The Botswana Pelo Initiative, has been established to help tackle the problem. (Pelo means heart in Setswana - a national language in Botswana.)

Nadeem Sarwar, Cardiovascular Epidemiologist at the University of Aberdeen and Principal Investigator of the project, explained:  "Recent medical research and health policies in sub-Saharan Africa have, understandably, predominantly focused on efforts to tackle the HIV pandemic in the region.

"This means strategies to prevent and control chronic diseases, including CVD, have been largely neglected. As a result, reasons for the rapidly increasing burden of CVD in sub-Saharan Africa are not known.

"The Botswana Pelo Initiative aims to establish a large and comprehensive programme of research to better understand the causes and determinants of CVD in Black African populations, including dietary, lifestyle and genetic factors, and whether HIV can increase the risk of CVD.

"The scheme will allow us to build local capacity for world class medical research into chronic conditions in sub-Saharan Africa, with the ultimate aim being to inform and help develop regional public health strategies to prevent and control CVD."

The first phase of the initiative - funded by the University of Aberdeen and in collaboration with the Heart Foundation of Botswana, the Botswana Ministry of Health and the Botswana National Food Technology Research Centre – will begin later this year.

Professor Kiran Bhagat, Chairman of the Heart Foundation of Botswana, said: "The aim of the first phase is to demonstrate the feasibility of conducting large scale research into CVD in what is a previously understudied population.

"This will involve assessing patients attending a specialist cardiac clinic in the capital of Botswana over a one year period, recording information about their dietary and lifestyle habits and taking physical measurements and blood samples."

Following successful completion of this phase, it is anticipated that investigations will be scaled up to involve other centres in Botswana with the aim of creating a research hub and the largest resource of its kind for the study of CVD in sub-Saharan Africa.

Professor Cairns Smith, Chair in Public Health at the University of Aberdeen, added: "This new important initiative will also strengthen links between Botswana and Scotland, and pave the way for further collaboration."