Fifty Years of Global Cardiovascular Research in Africa: A Scientometric Analysis, 1971 to 2021

Cardio-oncology care in Africa: current trends and disparities

The emerging discipline of cardio-oncology addresses the cardiovascular complications associated with cancer therapies. In sub-Saharan Africa (SSA), where both cardiovascular disease (CVD) and cancer-related mortality are increasing, the development of cardio-oncology services remains limited. This correspondence assesses the current state of cardio-oncology in Africa, highlighting significant gaps in infrastructure, workforce, and policy. Despite the establishment of a single accredited cardio-oncology unit in South Africa, formalized services are lacking in the majority of African countries, leading to fragmented care and increased incidence of treatment-related cardiotoxicity. Key barriers include inadequate specialist training, limited diagnostic resources and a lack of standardized care protocols. The paper outlines strategic interventions, including multidisciplinary training, integration of cardiovascular screening into oncology, research funding, and policy reform. Strengthening cardio-oncology services is essential to reduce the dual burden of cancer and CVD and improve clinical outcomes for affected populations in SSA.

African Research Output Within the Top 5 Vascular Surgery Journals

BACKGROUND

With Africa's population growth and an epidemiological shift from communicable to noncommunicable diseases, there is an urgent need to expand vascular surgery capacity across the continent. Despite a high disease burden, Sub-Saharan Africa contributes less than 1% of the global surgical research, with significant challenges in surgical infrastructure, access to consumables, and limited research output. This study assesses the publication output of African authors in the top 5 vascular surgery journals and explores trends in African vascular research.

METHODS

The top 5 vascular surgery journals, based on the CiteScore impact factor, were selected: Journal of Vascular Surgery, European Journal of Vascular and Endovascular Surgery, Journal of Vascular Surgery: Venous and Lymphatic Disorders, Annals of Vascular Surgery, and Journal of Endovascular Therapy. A PubMed search identified articles authored by researchers affiliated with African institutions. After removing duplicates and exclusions, 252 articles were analyzed using SPSS v27.0.1.

RESULTS

Annals of Vascular Surgery and Journal of Vascular Surgery were the most frequent publication venues, accounting for 32.5% and 28.6% of articles, respectively. Egypt and South Africa were the leading contributors, producing 44.8% and 28.2% of the research, respectively. Most studies were observational (81.3%), with only 7.1% being interventional. Research output has steadily increased, with 38.1% of articles published in the 2010s and 36.5% in the 2020s.

CONCLUSION

Vascular surgery is an emerging specialty in Africa, facing challenges, particularly in research. However, the number of publications in leading vascular surgery journals by African researchers is increasing, with Egypt and South Africa leading the way. More efforts are needed to enhance access to vascular surgery and research in Africa to boost the continent's contribution to global vascular surgery literature.

Sub-Saharan Africa's Contribution to Clinical Trials in International Acute Coronary Syndromes and Heart Failure Guidelines

Background

There is a growing burden of acute coronary syndrome (ACS) and heart failure (HF) in sub-Saharan Africa (SSA), yet outcomes remain poor compared to high-income countries. The European Society of Cardiology (ESC) international guidelines are pivotal to the delivery of evidence-based care; however, their representation of populations from SSA remains unclear.

Objectives

The purpose of the study was to evaluate the representation of populations from SSA in randomized controlled trials (RCTs) that inform ESC ACS and HF guidelines.

Methods

We systematically analyzed pharmacotherapeutic RCTs contributing to the 2021 ESC HF and 2023 ACS guidelines, extracting data from ClinicalTrials.gov. We assessed the proportion of RCTs that included contributions from countries in each World Bank income group, focusing on the involvement of SSA countries and examining temporal trends.

Results

Among the RCTs underpinning the ESC HF guidelines (n = 119) and ACS guidelines (n = 343), 75.9% were conducted exclusively in high-income countries. Middle-income countries were included in 22.2% of the trials, but none featured low-income countries. Within SSA, only South Africa was represented, contributing to 14.2% of HF and 8.2% of ACS RCTs. The number of HF RCTs involving populations from SSA has risen, from 2.6% in the 1990s to 50% post-2020 (P for trend< 0.05). For ACS RCTs, the proportion of trials involving populations in SSA increased from 1.8% pre-1990 to 23.4% during 2000 to 2009 (P for trend = 0.003), then declined to 11.3% in the following decade.

Conclusions

There is a marked underrepresentation of SSA countries in ACS and HF pharmacotherapy RCTs. South Africa is the sole contributor from the region, which may affect applicability and generalizability of global guidelines to populations in SSA.

Health Data Sciences and Cardiovascular Disease in Africa: Needs and the Way Forward

PURPOSE OF REVIEW

The rising burden of cardiovascular disease (CVD) in Africa is of great concern. Health data sciences is a rapidly developing field which has the potential to improve health outcomes, especially in low-middle income countries with burdened healthcare systems. We aim to explore the current CVD landscape in Africa, highlighting the importance of health data sciences in the region and identifying potential opportunities for application and growth by leveraging health data sciences to improve CVD outcomes.

RECENT FINDINGS

While there have been a number of initiatives aimed at developing health data sciences in Africa over the recent decades, the progress and growth are still in their early stages. Its maximum potential can be leveraged through adequate funding, advanced training programs, focused resource allocation, encouraging bidirectional international partnerships, instituting best ethical practices, and prioritizing data science health research in the region. The findings of this review explore the current landscape of CVD and highlight the potential benefits and utility of health data sciences to address CVD challenges in Africa. By understanding and overcoming the barriers associated with health data sciences training, research, and application in the region, focused initiatives can be developed to promote research and development. These efforts will allow policymakers to form informed, evidence-based frameworks for the prevention and management of CVDs, and ultimately result in improved CVD outcomes in the region.

Equity and representation in cardiology research: A comprehensive analysis of authorship from low and low-middle income countries in cardiology journals

Cardiovascular disease is the leading cause of mortality, disproportionately affecting low-income and low-middle-income countries (LICs/LMICs). Despite this, cardiology research commonly comes from affluent regions. This study assessed the authorship trends from LICs/LMICs in cardiology journals listed in PubMed from 2000 to 2022. The World Bank list was used to classify countries. The total number of articles published in the 138 cardiology journals was 529,359. The percentage of articles that included at least one author affiliated with LICs/LMICs institutions was 0.11 % and 2.23 %, respectively. Over the last decade, there has been an increase in the author's representation from LICs/LMICs; however, it is uneven, with some countries experiencing more significant increases (Zambia, Yemen, and Uganda for LICs, and India, Iran, and Lebanon for LMICs). Our findings highlight the inequity of research publication and invite our community to reflect on the need to develop strategies to improve representation from LICs/LMICs.

Using Technology to Deliver Cardiovascular Care in African Countries

PURPOSE OF REVIEW

This review aims to explore the applications of digital technology in cardiovascular care across African countries. It highlights the opportunities and challenges associated with leveraging technology to enhance patient self-monitoring, remote patient-clinician interactions, telemedicine, clinician and patient education, and research facilitation. The purpose is to highlight how technology can transform cardiovascular care in Africa.

RECENT FINDINGS

Recent findings indicate that the increasing penetration of mobile phones and internet connectivity in Africa offers a unique opportunity to improve cardiovascular care. Smartphone-based applications and text messaging services have been employed to promote self-monitoring and lifestyle management, although challenges related to smartphone ownership and digital literacy persist. Remote monitoring of patients by clinicians using home-based devices and wearables shows promise but requires greater accessibility and validation studies in African populations. Telemedicine diagnosis and management of cardiovascular conditions demonstrates significant potential but faces adoption challenges. Investing in targeted clinician and patient education on novel digital technology and devices as well as promoting technology-assisted research for participant recruitment and data collection can facilitate cardiovascular care advancements in Africa. Technology has the potential to revolutionize cardiovascular care in Africa by improving access, efficiency, and patient outcomes. However, barriers related to limited resources, supportive infrastructure, digital literacy, and access to devices must be addressed. Strategic actions, including investment in digital infrastructure, training programs, community collaboration, and policy advocacy, are crucial to ensuring equitable integration of digital health solutions.