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SA JOURNAL OF DIABETES & VASCULAR DISEASE
RESEARCH ARTICLE
VOLUME 15 NUMBER 1 • JULY 2018
21
approaches were conducted in a more detailed form in individual
follow-up visitations. These are not dealt with extensively in this
article. Also the low number of aware individuals and consequently
under-treatment limited the statistical analysis of data regarding
these aspects.
It is therefore not possible to extrapolate our findings to a larger
population at country level. However, this study reveals new data
about the prevalence, awareness, treatment and control of diabetes
and hypercholesterolaemia, and it is the most comprehensive
community-based study conducted to date in Angola.
Future direction
The inclusion of younger participants (15 to 24 years) allows a
better representation of the demographic structure of the country
and creates a baseline for future surveys. The emphasis for future
interventions should be aimed at younger populations in which
the prevalence of major risk factors is still low, so as to make a
difference in the long term.
In all LMIC, NCDs are the leading cause of death and disability,
killing nearly eight million people under 60 years old in 2013.
25
Over the past decade, the focus of assistance in these countries
has primarily addressed maternal and child health and infectious
diseases. Without setting these aside, there is an opportunity to
use structures that are already in place, to maximise resources. The
international community should consider expanding the mandate
of current programmes to include outcome-orientated measures
for improving general health and lifestyles.
Many of the methods of NCD prevention, management
and treatment, which are responsible for the decline in some of
these diseases in high-income countries, are inexpensive but are
not widely used in LMIC. These methods could be implemented
through established global health strategies, such as increased use
of low-cost drugs,
35
and improved access to NCD services for young
adults and people with low educational attainment.
36
Conclusions
This report reinforces the available data for the main CVD risk
factors in Angola and helps to build the basis for further prospective
studies, especially among the younger group in this region. We
provide the first evidence that hypertension prevalence is rising,
together with diabetes, when compared with previous studies in
the region.
Despite being a growing economy, Angola’s primary health
system may not be currently able to provide an adequate answer to
the changing health needs of this population. A gradual shift from
infectious diseases to NCDs is underway and this puts additional stress
on the reinforcement of primary care intervention in the region.
Acknowledgements
The authors thank the clinical staff of Bengo General Hospital for
establishing and supporting the follow-up consultation. We thank
all Dande-HDSS staff for their continuing support during fieldwork,
namely Joana Paz and Ana Oliveira for their field supervision
roles, Eduardo Saraiva for data entry supervision and database
management, Edite Rosário for the training of field workers and
assistance in data-collection procedures. Most importantly, we
thank the local administration and all of the individuals who agreed
to take part in the study.
This study was funded by the promoters of the CISA as follows:
Camões, Institute of Cooperation and Language, Portugal; Calouste
Gulbenkian Foundation, Portugal; Government of Bengo Province,
Angola; and the Angolan Ministry of Health. Also, the Eduardo dos
Santos Foundation, Angola and the Institute of Public Health of the
University of Porto, Portugal (ref UID/DTP/04750/2013) funded this
study. The funders had no role in the study design, data collection
and analysis, decision to publish, or preparation of the manuscript.
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