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Cardiovascular disease in Sub-Saharan African prisons: a scoping review
Amos Gavi1, Emma Plugge2, Marie Claire Van Hout1
1Public Health Institute, Liverpool John Moores University, Liverpool, UK.
Insights
Cardiovascular disease is a major concern in Sub-Saharan African prisons, with poor lifestyle factors contributing to high mortality. Enhanced health services and integrated NCD care are urgently needed for incarcerated populations.
Area of Science:
- Public Health
- Cardiology
- Criminology
Background:
- Sub-Saharan Africa faces a dual burden of non-communicable diseases (NCDs) and HIV.
- Cardiovascular disease (CVD) is a significant contributor to the disease burden in the region.
- Little is known about CVD in incarcerated populations in Sub-Saharan Africa.
Purpose of the Study:
- To conduct a scoping review of existing literature on cardiovascular disease in Sub-Saharan African prisons.
- To map and describe the current state of knowledge regarding CVD in this vulnerable population.
Main Methods:
- A systematic search of empirical literature was performed.
- Six Sub-Saharan African countries were included: Cameroon, Nigeria, Guinea, Burkina Faso, Ghana, and Ethiopia.
- Sixteen studies were charted, categorized, and thematically analyzed.
Main Results:
- Seven key themes emerged, including custodial deaths, cardiorespiratory fitness, CVD in elderly and female prisoners, dietary deficiencies, sleep patterns, and risk factors.
- CVD was the primary cause of natural deaths in autopsies of custodial deaths.
- Low cardiorespiratory fitness, poor sleep, and dietary deficiencies are linked to CVD burden in prisons, with specific neglect of elderly and female inmates.
Conclusions:
- This is the first scoping review of CVD in Sub-Saharan African prisons.
- There is a critical need for strategic focus on cardiovascular health within correctional facilities.
- Routine monitoring, expanded healthcare, and integration of NCD services with infectious disease programs (HIV, TB) are recommended.
Purpose:
The dual epidemic of non-communicable diseases (NCDs) and human immuno-deficiency virus (HIV) in Sub-Saharan Africa has increased substantially in recent years, with cardiovascular disease representing a significant contributor to the regional burden of disease. Very little is known about the cardiovascular health of people deprived of their liberty in the region. The purpose of this study was to collate extant literature on the topic.
Design/Methodology/Approach:
A scoping review mapped and described what is known about cardiovascular disease in prison populations in Sub-Saharan Africa. A systematic search of empirical literature with no date limitation was conducted in English. Sixteen studies representing six Sub-Saharan African countries (Cameroon, Nigeria, Guinea, Burkina Faso, Ghana and Ethiopia) were charted, categorised and thematically analysed.
Findings:
Seven key themes were identified: custodial deaths and autopsy; cardiorespiratory fitness and exercise; cardiovascular disease and elderly people in prison; cardiovascular disease and women in prison; dietary deficiencies; influence of sleep patterns on cardiovascular disease; and other associated risk factors. Most natural deaths at autopsy of custodial deaths were due to cardiovascular disease. Cardiorespiratory fitness was low in prisons, and poor sleep patterns and dietary deficiencies are likely contributors to the burden of cardiovascular disease in prisons. The needs of elderly and female prison populations are ill-considered.
Originality/Value:
To the best of the authors' knowledge, this is the first known attempt to scope extant literature on cardiovascular disease in Sub-Saharan African prisons. A strategic focus on the cardiovascular health of people in prison is warranted. Routine monitoring and expansion of existing prison health-care services and integration of NCD services with infectious disease (HIV and tuberculosis) programmes in prisons are required.
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