Dear Sir:
Kindly permit me to make a comment on this paper.
I read with great delight the paper written by Soliman and Juma1 titled “Cardiac Disease Patterns in Northern Malawi: Epidemiologic Transition Perspective” and published in J. Epidemiol 2008;18(5):204–208. I must thank and congratulate the authors for their good work and contribution to the clinical epidemiology of cardiac disease in Malawi.
However, in establishing the possible existence of epidemiologic transition in this country, the authors should have made a more determined effort to find similar previous work done in this country (research they claimed did not exist).
A MEDLINE search indicates that there were at least two previous studies—a clinical study by Brown2 and an echocardiographic study by Hakim.3 Conclusions that can be drawn from these studies include (see Table below):
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1.
The increase in the prevalence of hypertension,
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2.
The decrease or disappearance of syphilitic heart disease as a cause of cardiac morbidity in Malawi, possibly due to increased availability of antimicrobial agents, and
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3.
The gradual emergence of coronary heart disease.
| NO | Author | Year | No | HHDX (%) |
VHDX (%) |
DCM (%) |
CP (%) |
PDX (%) |
SHDX (%) |
IHD (%) |
CHD (%) |
Misc (%) |
| 1 | Soliman1 | 2008 | 3908 | 24.2 | 33.6 | 18.6 | — | 14.2 | 0 | 0.08 | 4.4 | 1.58 |
| 2 | Hakim3 | 1998 | 1153 | 13.3 | 25.1 | 22.0 | 3.9 | 22.4 | — | — | 3.8 | 9.7 |
| 3 | Brown2 | 1975 | 114 | 16 | 35 | 5 | 8 | 7 | 4.4 | — | 2.5 | 22.8 |
HHDX = Hypertensive heart disease, VHDX = valvular heart disease, DCM = Dilated Cardiomyopathy, CP = Cor pulmonale, PDX = Pericardial diseases, SHDX = Syphilitic heart disease, IHD = Ischemic Heart Disease, CHDX = Congenital heart disease, Misc = Miscellaneous
REFERENCES
- 1.Soliman EZ , Juma H. Cardiac disease patterns in northern Malawi: epidemiologic transition perspective . J Epidemiol. 2008;18(5):204–8 10.2188/jea.JE2008006 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Brown KG , Willis WH. Cardiac disease in Malawi . S Afr Med J. 1975;49(23):926–30 [PubMed] [Google Scholar]
- 3.Hakim JG , Manyemba J. Cardiac disease distribution among patients referred for echocardiography in Harare, Zimbabwe . Cent Afr J Med. 1998;44(6):140–4 [PubMed] [Google Scholar]