Cardiovascular Guidelines Dissemination in Kenya

Cardiovascular Diseases (CVDs) are the number one cause of death globally with more people dying annually from CVDs than from any other cause. In Kenya, it is estimated that 25% of hospital admissions are due to CVD.

In response to this, the Ministry of Health (MOH) in collaboration with other stakeholders spearheaded the development of National Guidelines for the Management of Cardiovascular Diseases to provide a standardized way of managing cardiovascular diseases in the country.

These guidelines were launched on the 31st May 2018. It is critical that these guidelines are disseminated across all counties health facilities to ensure we improve overall management of CVD in Kenya.

Kenya Cardiac Society (KCS) received funding from the World Heart Federation (WHF) to support in the dissemination of the guidelines which was done in phases. The initial phase took place in the period April 2019 – March 2020 in 5 counties Nyandarua, Kisumu, Kitui, Isiolo, Nyandarua.

We expanded the initiative to a second phase across four counties: Marsabit, Kilifi, Elgeyo Marakwet, and Kirinyaga. In this phase, we incorporated diabetes management and provided training for Health Records and Information Officers on hypertension and diabetes data management, including data audits.

With the launch of the newly revised National Cardiovascular Disease Guidelines on July 26, 2024, we aim to progress to a third phase.

Home Blood Pressure Telemonitoring Study

The study will enroll 100 patients with hypertension and provide them with HBPT and PCP for six months. The primary outcomes will be changes in hypertension control rate and drug adherence. Secondary outcomes will include patient and healthcare worker satisfaction.

Evaluation of an ECG based on AI algorithm

Detection of LVSD during the early and asymptomatic stages remains a major challenge. Whereas echocardiography can confirm the diagnosis, this imaging modality is not readily available in many resource-limited settings. Use of more readily available modalities to identify patients at high risk for LVSD can help in fast-tracking its confirmation with timely initiation of appropriate treatment.

Electrocardiography (ECG) based Artificial Intelligence (AI) algorithms have been validated to identify patients at high risk for LVSD in many populations tested. No such validation has ever been conducted.

Our objective is to evaluate the effectiveness of an ECG-based AI algorithm in predicting Heart Failure with Reduced Ejection Fraction (HFrEF) in a Kenyan population mainly in public hospitals.

Moreover, our expected Impact: The study aims to determine the feasibility of using ECG-based AI for early identification of patients at high risk for LVSD, potentially improving diagnosis and treatment in resource-limited settings.

Cvd Guidelines Dissemination, Hypertension And Diabetes Data Management- WHF Funded Project

Following our initial phase,  where we worked with five counties namely Nyandarua, Kisumu, Kitui, Isiolo and Nakuru county on the dissemination of the National Cardiovascular guidelines.

WHF continued to fund the project to support 4 more counties: Kirinyaga, Elgeyo Marakwet, Kilifi and Marsabit. This was to ensure we reach out to more healthcare workers on the improvement and standerdized way of overall management of CVD in Kenya. This involved Health Record and Information Officer training on hypertension and diabetes data management as well as data audits.

Interspire and Interpire Lp(a) Survey

The INTERASPIRE survey involved data collection in selected public hospitals in specific regions in each country. A consecutive sample of patients (>18 years and < 80 years) admitted with CHD was identified retrospectively. While interspire LP(a) study aimed to recognize CVD risks to assess patients' and physicians' knowledge and attitudes towards measuring and managing Lp(a) levels. It investigates patients' knowledge about cardiovascular risk, the role of Lp(a), and their willingness to change behavior. For physicians, the study will assess their knowledge, opinions on testing, and interest in forthcoming Lp(a)-lowering therapies.