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Many parts of the developing world, especially Sub-Saharan Africa, completely lack access to cardiac pacing. The authors initiated a multinational program to implement cardiac pacing in 14 countries in Sub-Saharan Africa (1996 to 2018), aiming to eventually build self-sustainable capacity in each country. This was based on an "on-site training" approach of performing procedures locally and educating local health care teams to work within resource-limited settings, with prospective evaluation of the program. In 64 missions, a total of 542 permanent pacemakers were implanted. In 11 of these countries, the first pacemaker implant in the country was through the mission. More than one-half of those initially listed as suitable died before the mission(s) arrived. The proportion of implantations that were completely handled by local teams increased from 3% in 1996 to 98% in 2018. These findings demonstrate the feasibility and effectiveness of a proctorship-based approach to the development of local cardiac pacing capabilities in Sub-Saharan African nations., (Copyright © 2019. Published by Elsevier Inc.)

The objectives of our study were to evaluate the perception and the knowledge of cardiovascular risk factors (CVRF) by the population and their management by health care workers (HCW) in Burkina Faso. The survey targeted specific socio-professional groups representative of Burkina Faso. The survey team administrated a questionnaire and measured some constants. The sampling method was empiric selection by quotas. The sample was composed of 2,000 subjects: 1,073 men, 927 women, 1,800 represents of the general population and 200 HCW. Of 1,800 non health workers, 1,475 had ever heard about hypertension. The representation of hypertension as "a disease" decreased with instruction level while its reprentation "a risk factor" increased with instruction level (p < 0.001). The main sources of information on CVRF were talks with parents and friends, radio broadcasting and discussion with HCW. One hundred and forty of 200 HCW defined hypertension as an elevation of blood pressure, mainly systolic (130 cases) according to WHO criteria. Hypertension was classified after alcohol, tobacco smoking, obesity as the fourth CVRF. One hundred and seventy seven of 302 cases of hypertension were previously unknown: 97 of the 125 old cases were treated and 74 had not normal blood pressure levels. Hypertension and other CVRF are not well-known in Burkina Faso population and are not well-managed by HCW. Political decision makers and donor institutions should pay more attention on the public health problem represented by hypertension and other CVRF in developing countries because of they are not communicable.