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Cardiovascular disorders vary throughout the world in type and distribution especially between the developed and the developing countries. Data on spectrum of cardiovascular diseases in Ethiopia is scarce.To assess the spectrum of cardiovascular disorders at Tikur Anbessa Specialized Tertiary Referral Hospital.A record review of patient registers from January 2001 to December 2012 was done for 3282 Ethiopian patients with confirmed cardiovascular disorders at adult Cardiology clinic and Neurology clinic of Tikur Anbessa Specialized hospital. Spectrum of valvular heart disease, heart failure, hypertension, ischemic heart disease, congenital heart disease, arrhythmias, cardiomyopathies, cerebrovascular diseases, and peripheral vascular diseases, defined by Physician International Classification of Diseases, Version 9, codes, were directly standardized to the population. Descriptive statitistics was applied to present results.The study population contained more women (n = 1937 [59.0%]) than men. The mean age of the patients was 31.6 +/- 16.6 years. Women were younger than men (mean 29.6 [SD 15.1] years vs 34.52 [18.3] years). Valvular Heart Disease was the most common primary diagnosis in 2036 (62.0%) with significantly higher proportion in the 3rd decade of life. About 300 (9.1%) of the patients were diagnosed with heart failure. Other major diagnoses included hypertension 482 (14.7%), cerebrovascular diseases or stroke 377 (11.5%), congenital heart disease 279 (8.5%) and ischemic heart disease 224 (7.4%). Fifty seven (26.5%) patients with ischemic heart disease had diabetes mellitus.While valvular heart disease is the commonest cardiovascular disorder in Ethiopian patients at the largest public hospital of the country, ischemic heart disease has dramatically increased over the years. It is high-time that effective population-based, health promotive strategies for primary prevention as well as secondary measures for the established cardiovascular disorders and risk factors are in place.

Rheumatic heart disease (RHD) is the most important cardiovascular disease in hospital practice in Ethiopia. However, the prevalence rate of RHD at the community level remains unknown. The current survey was undertaken to estimate its prevalence among schoolchildren of a central Ethiopian rural town (Butajira). Accordingly, 92.8% of the entire schoolchildren (n = 3.235) in the town were screened. Their mean age was 13.4 +/- 3.5 years. Fifteen children, accounting for a rate of 4.6/1,000, were noted to have findings consistent with RHD. Females and older children were more frequently affected. Only 2 of the 15 students were aware of their disease, and neither of them were on regular secondary prophylaxis. Our finding is consistent with the hospital-based reports that showed RHD to be a common disorder in clinical practice. At the same time, the lack of awareness about their disease noted among the cases is worrisome and deserves serious attention.

The objectives of the study were to evaluate severity of rhenumatic heart disease (RHD) using age at time of death as its indicator and to look for factors associated with the severity. Retrospective study of consecutive cardiovascular deaths in the medical wards of Tikur Anbassa Teaching Hospital (TAH) from January 1995 to December 2001 was carried out. Information on age at the time of death, sex, type of valve lesions, status of secondary prophylaxis, presence or absence of arrhythmia, infective endocarditis, embolic phenomena, co-morbid illness, immediate cause(s) of death and duration of follow up at health institutions were obtained There were a total of 457 cardiovascular deaths including cerebrovascular accidents (CVA). 121(26.5%) were due to RHD. Charts of 115 RHD patients were available for detailed analysis. The overall mean age at the time of death was 25.89+/-11.05 years. The median age for males was lower than that of females (19 years, I.Q. 16-32 versus 25 years, IQ 15 - 30 years), but not statistically significantly different (p = 0. 10). There were more female deaths accounting for 57.4 %. About 70% of RHD patients died from congestive heart failure. Eleven per cent (13 patients) each died from systemic embolism and co-morbid conditions. Combined mitral and aortic valve disease within a patient accounted for majority (42.6%) of the lesions followed by combined mitral regurgitation and stenosis (24.4%). Isolated mitral stenosis, or regurgitation was a relatively less common cause of death. Aortic valve lesion without mitral valve involvement was a rare cause (3.5%) of death. In conclusion RHD in our patients ran more aggressive course as indicated by death occurring at much younger age than in even the preprophylaxis era in western world. The more frequent combined valve lesions and infrequent secondary prophylaxis may significantly contribute to the rapid course, but cannot fully explain the very low mean age. Factors responsible for rapid course in an Ethiopian need to be addressed urgently.

The potential medical transmission of HIV through unsafe medical injections was evaluated in 16 rural health institutions in Ethiopia. Most institutions reported re-using disposable needle/syringes, and 12% of observed injections were given with used, disposable syringes prepared for re-use. Analysis of used needle flushes showed no HIV RNA; however, the sensitivity of our method was limited. Despite the re-use of disposable needles, medical injection practices are not likely to contribute significantly to HIV transmission in this region.

Background: Although the burden of cerebrovascular accident is not known in Africa, including Ethiopia, it s a frequent cause of mortality and morbidity in hospital practice. Stroke in the young is associated with different spectrum of risk factors and treatment outcome as compared to stroke in the older age group. Method: To assess potential risk factors associated with stroke; and to compare the types and frequencies of these potential risk factors among stroke in the young and stroke in the older age groups, a retrospective case study of all stroke patients admitted to Tikur Anbassa Teaching Hospital over six years period, September 1990 to August 1996, was undertaken. Results: Two hundred and fifty nine patients satisfying the definition of stroke were admitted to Tikur Anbassa Teaching Hospital. Stroke in the young accounted for 28% (73 patients). Hypertension was the commonest risk factor among both age groups. Rheumatic heart diseases (RHD) was the second commonest risk factor after hypertension present in 29% of stroke in the young while it was absent in the older age. All the RHD cases had mitral valve involvement (mainly mitral stenosis), nearly all having milder forms of the disease. Only 9 of 21 patients with RHD had established atrial fibrillation. Conclusion: Rheumatic heart disease is an important risk factor among stroke in the young and type of valve involved rather than severity of disease is related to occurrence of stroke. If confirmed on subsequent prospective studies this finding will have an impact on indication for anticoagulation in RHD. [Ethiop.J.Health Dev. 2002;16(3):309-315]