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VOLUME 15 NUMBER 1 • JULY 2018
3
SA JOURNAL OF DIABETES & VASCULAR DISEASE
EDITORIAL
From the Editor’s Desk
Correspondence to: FA Mahomed
Head of Clinical Unit; Endocrinology, Department
of Internal Medicine, University of the Free State,
Bloemfontein
e-mail:
MahomedFA@ufs.ac.zaS Afr J Diabetes Vasc Dis
2018; 1
5
: 3
T
his issue covers a diversity of topics from South Africa and
other countries in sub-Saharan Africa.
With the projected increase in prevalence of diabetes
mellitus, a corresponding increase is expected in associated
complications. Ojobi and co-workers reviewed the bacteriology of
diabetic foot ulcers in Nigeria (page 4). Most of the patients were
farmers.
Staphylococcus, E coli, Pseudomonas
and
Streptococcus
were themajor isolates. Their resistance pattern favoured quinolones
and not penicillin. A number of antibiotic choices are available for
use in diabetic foot ulcers,
1
but local resistance patterns determine
the final choice.
Ntuli
et al.
investigated risk factors for diabetic foot ulcers in
a primary healthcare setting in Johannesburg, South Africa. They
show a high prevalence of neuropathy, structural abnormalities and
peripheral vascular disease in the primary care setting and make a
strong case for the provision of adequate podiatry services at this
level. While infectious diseases make up a large part of the disease
burden in South Africa, non-communicable diseases also contribute
to this burden and healthcare services need to cater for this.
2
Since morbidity from cardiovascular disease is a major burden
in Nigerians with type 2 diabetes, predicting and quantifying
cardiovascular risk could help in the management of diabetes and
its complications. Udenze and Amadi (page 8) assessed the risk of
cardiovascular disease in adult Nigerians with type 2 diabetes or
the metabolic syndrome, using the Framingham risk score, and
concluded that patients on treatment had high cardiovascular risk
scores and risk factor control was not optimal.
A large proportion of cardiovascular disease is the result of
modifiable risk factors, such as tobacco and alcohol consumption,
unhealthy diet and physical inactivity. These risk factors can result
in obesity, hypertension, diabetes or hypercholesterolaemia. Pedro
and co-workers (page 13) determined the prevalence, awareness,
treatment and control of cardiovascular risk factors in Angolan
patients. They also compared rural and urban populations and
describe important factors, such as a high rate of obesity in this
group of patients, representing the nutritional transition in Africa.
These findings are important in guiding public health programmes
Gulmez and colleagues studied left atrial function in patients
with early type 2 diabetes. Patients had significant alterations in
cardiac parameters and this study suggests early cardiac functional
impairment in diabetes. Left atrial volume may be an important
indicator of left ventricular dysfunction and even risk of atrial
fibrillation.
3
Bashir and Cumber reviewed cerebrovascular disease in Sudan
(page 29). They point out that stroke is a major cause of disability
in the country and that a sound health-systems approach is needed
for adequate stroke care in Sudan.
The 2017 SEMDSA diabetes management guidelines are
summarised by Webb in an easy-to-read, well-written article
(page 37).
References
1. Kalish J, Hamdan A. Management of diabetic foot problems.
J Vasc Surg
2010;
51
(2): 476–486.
2. Mayosi BM, Flisher AJ, Lalloo UG, Sitas F, Tollman SM, Bradshaw D. The burden of
non-communicable diseases in South Africa.
Lancet
2009;
374
(9693): 934–947.
3. Tsang TSM, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Left atrial volume as a
morphophysiologic expression of left ventricular diastolic dysfunction and relation
to cardiovascular risk burden.
Am J Cardiol
2002;
90
(12): 1284–1289.
Tribute to Professor Bongani Mawethu Mayosi
‘A friend, a brother, a mentor, a leader, a champion, a warrior and a true son of Africa’
Prof Bongani Mayosi
, 51-year-old
dean of Health Sciences at the University
of Cape Town tragically passed away on
Friday, 27 July in Cape Town.
PASCAR joins many, with great
sadness, in mourning a man who
truly impacted on and inspired all
who crossed his path. No one was left
untouched by Bongani’s presence.
Bongani Mayosi made his name as one of the world’s
top cardiology researchers and his legacy will continue in
the African research and networks he fostered in especially
rheumatic heart disease in Africa. As a leader, he truly believed
in inclusive leadership, and
ubuntu
was ingrained in who he
was. Bongani at his time of passing was ex-officio president
of the Pan-African Society of Cardiology (president 2013–
2017). We can only hope to emulate him and carry his legacy
forward.
PASCAR expresses its condolences to his spouse Nonhlanhla
Khumalo, their two daughters, the extended family and his
cardiology colleagues in Africa and all over the world. Africa
has lost a truly exceptional leader.