The Else Kröner Center for Heart and Lung Diseases (EKC-HLDC) was inaugurated in 2021 with the aim to establish services for chronic heart and lung conditions and to train medical doctors for chronic care of these diseases. Linked community screening programs are a central part of the EKC-HLDC to improve awareness, as well as diagnostic and treatment cascades.
In sub-Saharan Africa, the awareness of hypertension, heart failure, and obstructive lung diseases such as asthma and COPD is low. These diseases are diagnosed and treated in a minority of patients only, despite their high morbidity and mortality. In order to improve the management and prevention of these diseases, the Else Kröner Center for Heart and Lung Diseases (EKC-HLDC) was established in Ifakara.
- Implementation of diagnostic and therapeutic services for in- and outpatients with cardiac and pulmonary diseases including echocardiography and spirometry at the specialist level
- Training and education for healthcare professionals, including medical doctors, students, nurses and community health workers in methodology and practice relevant to heart and lung diseases
- Establishing an ongoing patient cohort from August 2021, allowing to measure health indicators, progresses made, and representing a sustainable platform for research projects
- Implementation of community health and outreach activities to increase awareness and knowledge in the general population and for village healthcare workers
The HLDC is nested within the collaboration of the Ifakara Health Institute, and the St Francis Referral Hospital in Tanzania, the Charité University Hospital in Berlin, Germany, and the University Hospital Basel and Swiss TPH in Switzerland. Following the concept of “train the trainers”, expert healthcare staff are teaching colleagues in cardiology and respiratory medicine, and this concept will be adapted and adopted for other referral hospitals in Tanzania.
Dedicated medical personnel are trained in performing echocardiography, spirometry, electrocardiography (ECG), 24-hour Holter ECG, 24-hour blood pressure measurement, measurement of the international normalized ratio (INR) in anticoagulated patients with warfarin, and Carbon-monoxide (CO)-measurements – all following 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 per day, and performs 10 echocardiographies daily.
In 2021, the first community outreach efforts were initiated in collaboration with the town medical officer (TMO) office. Patients are screened for arterial hypertension, heart failure, and obstructive lung disease at the community health care level, and villagers are regularly informed on non-communicable diseases, their manifestations and potential complications, as well as on how to prevent and manage them.
Several clinical research projects are conducted within the framework of the EKC-HLD; i.e., a patient cohort for heart and lung diseases, the peripartum cardiomyopathy follow-up study, and the lung (portable) ultrasound study. The EKC-HLD will be handed over to our Tanzanian partners the St. Francis Referral Hospital and the Ifakara Health Institute – once the establishment of a core staff team is completed.