1. Kenyatta National Hospital Nairobi, Kenya Rita Kuwahara 28 August 2012 Contact: rita_kuwahara@med.unc.edurita_kuwahara@med.unc.edu

2. Cardiology and Emergency Medicine Research/Clinical Elective Clinical Component: – ERMD 414: Emergency Care in East Africa Accident and Emergency Medicine Neurosurgery Internal Medicine/Cardiology Research Component: – Cardiology and Emergency Medicine UNC Advisor: Dr. Ian Martin KNH Coordinator: Naomi Mugira UNC Statistician: Meredith Arasaratnam Kenyatta National Hospital – Kenya’s National Referral and Teaching Hospital – 1800 Beds

3. Access to Care Among Patients with Cardiovascular Disease Presenting to the Emergency Department of a Tertiary Referral Hospital in Nairobi, Kenya Enrollment Criteria – Age 18-89 years – Patients Diagnosed with: Hypertension Heart Disease Stroke Deep Vein Thrombosis – Patients admitted to hospital through ED Protocol Approved by UNC IRB and University of Nairobi Ethics Committee Data Collection – Questionnaires 112 Patient Interviews Data Elements: – Patient Demographics – Type(s) of Cardiovascular Disease – CVD Risk Factors – Healthcare Utilization Patterns – Barriers to Medical Care

4. Preliminary Results Barriers to Healthcare Cardiovascular Disease is a Significant Problem in Kenya! Average Age of CVD Onset Most Prevalent CVD Diagnoses: -Hypertension -Congestive Heart Failure -Stroke Newly Diagnosed CVD: 27%