Screening uptake of ischemic heart disease in adults aged 25-64 years in Yaounde-Cameroon: a population-based study

Abstract

Ischemic heart disease is the leading cause of mortality and morbidity worldwide, with an increasing mortality in sub-Saharan Africa, and is the second leading cause of death among chronic diseases in Cameroon. In spite of the fact that preventive cardiovascular health screenings have been demonstrated to be crucial in identifying and treating people with high risk for heart disease and premature death, there remains a low accessibility to screening services for ischemic heart disease. The screening uptakes of ischemic heart disease and that of its risk factors among adults in the city of Yaounde are unknown. Our study purported to provide deep insights into the screening rate of heart disease, with that of its major modifiable risk factors, while closely evaluating the determinants that are associated to or predict that uptake in the city of Yaounde, Cameroon. Method It was a population-based cross-sectional study supposed to sample 422 adults age between 25-64 years old in Yaounde. It consisted in a multistage sampling method using a 36-item semi-structured questionnaires to obtain respondents’ data on the knowledge and awareness of heart disease, the sociodemographic characteristics, health status, the uptake of heart disease and its risk factors, the perceived barriers to screening services, the dimensions of healthcare access and the attendance to cardiovascular disease screening campaigns. The analysis was done using the Statistical Package of the Social Science (SPSS 21) software, with the use of the Chi-square for assessing the associations and the Logistic regression to determine the predictors of our main outcomes at a set statistical significance level of 0.05. Prior to our study implementation, a pilot study was conducted until after we were granted an Ethical approval from the Institutional Review Board of Hanyang University. Results The response rate was 99.5%, and the median age of the respondents was 34 years (IQR=17 years) with 52.4% of males. The screening uptake of ischemic heart disease was 16.9%, while the screening uptake of the risk factors of heart disease was 81%. The significant predictors for the uptakes were the knowledge of the risk factors (P=0.05) and warning signs of heart disease (P=0.03), the awareness (P<0.001), age (P<0.001), being female (P=0.001), affordability (P=0.03), the uptake of the risk factors (P=0.03), the personal lifestyles (P=0.02), the barriers (accessibility) to screening services (P=0.01), and the attendance to cardiovascular diseases screening campaigns (P=0.001). Conclusion The screening uptake of ischemic heart disease is very low among adults in Yaounde. Social factors accounting for the disparities between screened and unscreened groups were the knowledge and awareness of ischemic heart disease, female gender, affordability, accessibility, health status, the screening of risk factors, lifestyles, and perceived barriers to the screening and the attendance to screening campaigns for cardiovascular diseases.