Knowledge and awareness of and perception towards cardiovascular disease risk in sub-Saharan Africa: A systematic review

Article type
Authors
Boateng D1, Wekessah F2, Browne J3, Agyei-Baffour P4, de-Graft Aikins A5, Smit J6, E Grobbee D6, Klipstein-Grobusch K6
1Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands/ 1. School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
2Julius Center for Health Sciences and Primary Care,University Medical Centre Utrecht, The Netherlands/ African Population and Health Research Center, Nairobi, Kenya
3Julius Center for Health Sciences and Primary Care,University Medical Centre, Utrecht, The Netherlands/ Kwame Nkrumah University of Science and Technology, Ghana
4Kwame Nkrumah University of Science and Technology, Ghana
5Regional Institute for Population Studies, University of Ghana, Legon, Ghana
6Julius Center for Health Sciences and Primary Care,University Medical Centre, Utrecht, The Netherlands
Abstract
Background:Cardiovascular diseases (CVDs) are the most common cause of non-communicable disease mortality in sub-Saharan African (SSA) countries. Evidence on the awareness and knowledge level of cardiovascular diseases (and associated risk factors) among populations of sub-Saharan Africa is scarce.

Objectives:This review aimed to synthesise available evidence of the level of knowledge of CVDs in SSA.

Methods: Five databases were searched for publications up to December 2016. The quality of the quantitative and quantitative studies was assessed based on National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Critical Appraisal Skill Programme (CASP) tool, respectively. Narrative synthesis was conducted for knowledge level of CVDs, knowledge of risk factors and clinical signs, factors influencing knowledge of CVDs and source of health information on CVDs. The review was registered with Prospero (CRD42016049165).

Results: Twenty studies were included in this review: 18 quantitative and 2 qualitative, Figure 1. This review identified low knowledge level, poor perception of CVDs, and knowledge gaps for risk factors and clinical symptoms of CVDs. In most studies, less than half of the subjects had good knowledge of CVDs. The percentage of participants unable to identify a single risk factor and symptom of CVDs ranged from 1.8% to 56%, and 9% to 77.3%, respectively. Educational level and type of residence influenced knowledge level of CVDs among SSA populations, Figure 2.

Conclusions: Knowledge level of CVDs, risk factors and warning signs for CVD are low among sub-Saharan African populations, and this is linked to low educational attainment and rural residency. The findings of this study prompt educational campaigns to enhance knowledge of CVDs in both rural and urban communities.