Else Kröner Center for Heart and Lung Diseases
The Else Kröner Center for Heart and Lung Diseases (EKC-HLDC) was inaugurated in 2021 with the aim of establishing services for chronic heart and lung diseases and training physicians in the chronic care of these diseases. Linked community screening programmes are a key part of the EKC-HLDC to improve awareness, diagnostis and treatment cascades.
Awareness of hypertension, heart failure and obstructive lung diseases such as asthma and COPD is low in sub-Saharan Africa. Only a minority of patients are diagnosed and treated for these diseases, despite their high morbidity and mortality. To improve the management and prevention of these diseases, the EKC-HLDC was established in Ifakara.
Project Objectives
- Implementation of diagnostic and therapeutic services for inpatients and outpatients with cardiac and pulmonary diseases, including echocardiography and spirometry at specialist level
- Training and education of healthcare professionals, including medical doctors, students, nurses and community health workers in cardiac and pulmmonary disease methodology and practice
- Establishment of an ongoing patient cohort from August 2021 to measure health indicators and progress and provide a sustainable platform for research projects
- Implementation of community health and outreach activities to increase awareness and knowledge among the general population and village health workers
Project Outline
The HLDC is part of the collaboration between the Ifakara Health Institute, and the St Francis Referral Hospital in Tanzania, the Charité University Hospital in Berlin, Germany, and the University Hospital of Basel and Swiss TPH in Switzerland. Using a “train the trainers” approach, expert health staff are teaching colleagues in cardiology and respiratory medicine, and this concept is being adapted and adopted for other referral hospitals in Tanzania.
Dedicated medical staff are being trained to perform echocardiography, spirometry, electrocardiography (ECG), 24-hour Holter ECG, 24-hour blood pressure measurement, International Normalized Ratio (INR) measurement in anticoagulated patients on warfarin, and carbon monoxide (CO) measurement – all according to international standards and guidelines. Of note is that half of the EKC-HLD staff is supported by the SFRH, the clinic sees up to 30 patients a day and performs 10 echocardiographies a day.
In 2021, the first community outreach efforts were initiated in collaboration with the office of the Town Medical Officer (TMO). Patients are screened for arterial hypertension, heart failure and obstructive lung disease at the community health care level, and villagers are regularly informed about non-communicable diseases, their manifestations and potential complications, and on how to prevent and manage them.
Several clinical research projects are conducted within the framework of the EKC-HLD, inlcuding a heart and lung disease patient cohort, a peripartum cardiomyopathy follow-up study and a lung ultrasound study. Once a core staff team has been estanlished, the EKC-HLD will be handed over to the St. Francis Referral Hospital and the Ifakara Health Institute.
