Date Published: April 1, 2019
Author(s): Julian T. Hertz, Deng B. Madut, Revogatus A. Tesha, Gwamaka William, Ryan A. Simmons, Sophie W. Galson, Francis M. Sakita, Venance P. Maro, Gerald S. Bloomfield, John A. Crump, Matthew P. Rubach.
Little is known about community knowledge of myocardial infarction symptoms and perceptions of self-risk in sub-Saharan Africa.
A community survey was conducted in northern Tanzania, where the prevalence of cardiovascular risk factors is high. Households were selected randomly in a population-weighted fashion and surveys were administered to self-identified household healthcare decision-makers. Respondents were asked to list all symptoms of a heart attack and asked whether they thought they had a chance of suffering a heart attack. Associations between participant sociodemographic features and responses to these questions were assessed with Pearson’s chi-squared and the Student t test.
There were 718 survey participants, with median (IQR) age 48 (32, 62) years. Of these, 115 (16.0%) were able to identify any conventional symptom of a heart attack, including 24 (3.3%) respondents who cited chest pain as a possible symptom. There was no association between ability to identify a conventional symptom and gender, level of education, socioeconomic status, urban residence, or age. Of respondents, 198 (27.6%) thought they had a chance of suffering a heart attack. Older respondents were more likely to perceive themselves to be at risk (P < .001), but there was no association between perception of self-risk and gender, level of education, socioeconomic status, or urban residence. In northern Tanzania, knowledge of myocardial infarction symptoms is poor among all segments of the population and only a minority of residents perceive themselves to be at risk of this disease. Educational interventions regarding ischemic heart disease are urgently needed.
A total of 718 persons participated in the survey, and their sociodemographic features are summarized in Table I. The median (IQR) age of participants was 48 (32, 62) years, and 485 (67.5%) of respondents were female. The majority of respondents lived in rural areas (563, 78.4%) and did not have post-primary education (537, 74.8%).Table ISociodemographic features of household survey respondents, Moshi Urban, Moshi Rural, and Hai districts, 2018 (N = 718)Table In(%)Female485(67.5)Urban residence155(21.6)Education None40(5.6) Primary497(69.2) Secondary132(18.4) Post-Secondary49(6.8)Have health insurance230(32.0)Religion Christian584(81.3) Muslim115(16.0) Other19(2.6)Chagga tribe535(74.5) Median(Range)Age, years48(17, 99)Household size, number of persons4(1, 13)SES score0.29(0, 1.01)SES, socioeconomic status.
This study is among the first to examine community knowledge of myocardial infarction symptoms and self-perceived risk in SSA. In a community with high prevalence of risk factors,13., 14. only a minority of residents perceived themselves to be at risk for suffering a heart attack. Furthermore, knowledge of myocardial infarction symptoms was limited. These findings underscore a grave need for educational programming to improve community awareness of ischemic heart disease.