Biomedical subjects
Publications and source records attributed to S R Dodu.
Rheumatic fever and rheumatic heart disease can be prevented by simple methods of primary health care. Well-organized prevention programmes can be cost-effective. Lasting benefit depends on the maintenance of both local interest and financial support from governments.
Developing countries are subject to the same risks that have contributed to the high incidence of cardiovascular diseases in the already developed countries. Improvements in life expectancy at birth lead to predictable shifts in the cause-of-death structure over time. The stage at which cardiovascular diseases may be considered to be 'actively emerging' corresponds to a life expectancy level between 50 and 60 years and, at this level, cardiovascular disease mortality accounts for 15-25% of all deaths. The average life expectancy at birth in developing countries for the year 2000 is projected to be 60 years or more and it may be expected that by that time cardiovascular diseases would be actively emerging or established in virtually every country. In many developing countries today, life-style pattern that is associated with high rates of coronary heart disease is not yet widespread and it is therefore logical that a strategy of prevention should include efforts to inhibit the entrenchment and spread of unhealthy life-styles in the community (i.e., primordial prevention). At the country level, cardiovascular disease prevention and control cannot be considered in isolation and must be related to prevailing national health priorities and competing claims from other sectors of development. In poorer countries where life expectancy is below 50 years primordial prevention activities are likely to be restricted--perhaps to smoking and hypertension control. In middle-income countries a broader based approach to primordial prevention is feasible and is more likely to be acceptable.
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Hypertension and related complications appear, from clinical impression, to be increasing problems in urban Ghanaians. In early 1973 we conducted a blood pressure survey in 20 rural Ghanaian villages to determine the prevalence of hypertension, in comparison with studies done in Accra residents and black Americans. Rural Ghanaians had mean systolic and diastolic blood pressures which were lower at all ages than the urban groups. 2-5% of the subjects aged 16 to 54 years had diastolic blood pressures of 95 or higher mm Hg. These findings are discussed in view of the proposed hypertension control programme in Accra. We conclude that hypertension is not a significant health problem in rural Ghanaians and that large-scale hypertension case-finding and intervention programmes should be confined to urban populations.
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Iron absorption as measured by a faecal recovery method in young adult males living in a tropical zone was high, even in the absence of anaemia. There was an inverse relation between the iron absorption and the packed cell volume. The highest absorption was found in sickle cell anaemia patients, where the packed cell volume is the lowest. The incorporation of iron was also the fastest and greatest in this group. In the controls the iron absorbed accumulated in the marrow and the spleen on the first day; in the sickle cell anaemia group the spleen has an insignificant role in iron storage. The growing radioactivity in the liver parallels that of the heart in the group of sickle cell anaemia patients; however, it remains low in the spleen in the same group, implying a diminution of splenic blood flow. In the sickle cell haemoglobin C and the haemoglobin C patients, the liver and spleen have an intermediate position between that of the sickle cell anaemia group and the control group.