Published in PLOS One on 2026-03-25, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Wingston Felix Ng’ambi, Janne Estill, Fatma Aziza Merzouki, Cosamas Zyambo, Jonathan Chiwanda Banda, David Beran, Olivia Keiser, Muhammad Farooq Umer
Source: PLOS One • DOI 10.1371/journal.pone.0320276
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Cardiovascular diseases (CVDs) are responsible for nearly a third of deaths globally. We conducted this study to understand the prevalence of history of CVDs, their prevention and treatment in twelve African countries using the World Health Organization STEPwise Approach to Surveillance (WHO STEPS) data.
We used secondary STEPS data extracted from 12 African countries between 2014 and 2019. CVD was defined as a self-reported history of heart attack, angina, or stroke. Weighted percentages, counts, weighted odds ratios (OR), and the corresponding 95% confidence intervals (95%CI) were computed using the R software. We fitted logistic regression models to select the predictor variables from a regression model for CVD prevalence, CVD prevention and CVD treatment binary endpoints.
Amongst 60,294 individuals, the prevalence of CVD was 5%. The CVD prevalence was higher in older individuals, females, individuals with hypertension, smokers, people with high salt intake, and in certain countries. Eleven percent of the 23,630 individuals at high risk of CVD (≥40 years) but without a history of the disease received CVD prevention treatment. Amongst the 2,895 persons with CVDs, 22% received treatment and counselling for CVD: 34% (n = 215) receiving aspirin, 32% (n = 202) counselling for CVD risk factors, 11% (n = 66) statins, and 24% (n = 148) both statins and aspirin. The uptake of CVD treatment varied by hypertension status, sex, age and country.
The prevalence of CVD was relatively low and CVD treatment uptake was sub-optimal. Concerted efforts must be made to accelerate the diagnosis and expand treatment for CVDs in Africa if to curtail untimely deaths attributable to CVDs.
Introduction
Despite the relatively low prevalence of cardiovascular diseases (CVDs) in Africa compared to developed countries, there is evidence of a steady increase, which poses a significant public health concern. One of the aims of the United Nations Sustainable Development Goals is to reduce premature mortality from non-communicable diseases (NCDs) by a third by the year 2030 [1]. The CVDs, like coronary heart disease and stroke, are the most common NCDs globally responsible for an estimated 9.6 million male deaths and 8.9 million female deaths worldwide in 2019, of which 6.1 million of were among people aged 30–70 years [2]. Of these deaths related to CVDs, more than 75% occurred in low- and middle-income countries [3]. Heart attacks and strokes accounted for 85% of these fatalities [4]. Globally between 1990 and 2020 the age standardized DALYs for CVDs equal those of the communicable, maternal, neonatal and nutritional (CMNN) diseases combined.
While infectious diseases have historically been the primary focus of public health efforts in the region, CVDs are becoming a significant and increasing problem [5]. The prevalence of CVDs in Africa has been steadily increasing over the past few decades [5]. Despite the growing prevalence of CVDs in Africa, there is a lack of multi-country analyses assessing the full care continuum; from diagnosis to treatment; in this region. According to the Global Burden of Disease (GBD) project, prevalence of CVDs and mortality differ substantially between high-income and low-income regions. Particularly, Africa is seeing rising rates of diabetes, obesity, and hypertension; all of which are significant causes of CVD; but these patterns are not well-represented in international research initiatives. The region is understudied in comparison to more resourced locations because of issues with infrastructure, data availability, and healthcare systems [6]. Furthermore, while global trends in prevalence of CVDs and their associated risk factors have been extensively studied; Africa remains relatively understudied despite the rising burden of CVDs [6]. A dearth of comprehensive and localised studies that are suited to the region’s particular socioeconomic and healthcare contexts is further highlighted by recent reports from GBD collaborations that emphasise the need to shed light on the CVD epidemiology in Africa. Through region-specific analysis, these initiatives are starting to address modifiable risk factors; nevertheless, there are still gaps in assessing the effectiveness and implementation of interventions [7]. Efforts to address this growing health concern, like improved healthcare access, awareness campaigns, and research to develop region-specific prevention and treatment strategies, are critical [8,9]. For example, the World Health Organization developed the package of essential noncommunicable disease interventions (PEN) and related strategies (PEN-PLUS) for resource limited settings covering also the care of severe NCDs in these settings [2,10].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Wingston Felix Ng’ambi, Janne Estill, Fatma Aziza Merzouki, Cosamas Zyambo, Jonathan Chiwanda Banda, David Beran, Olivia Keiser, Muhammad Farooq Umer. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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