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A5953 Heart failure in sub-Saharan Africa

a contemporaneous systematic review and meta-analysis

Agbor, Ndip1; Essouma, Mickael2; Ntusi, Ntobeko3; Nyaga, Ulrich4; Bigna, Jean Joel5; Noubiap, Jean Jacques6

doi: 10.1097/01.hjh.0000548638.47932.4b
02-CLINICAL SCIENCE: PDF Only
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Objectives: To summarise available data on the prevalence, aetiology, treatment, prognosis and cost of treatment of heart failure (HF) in sub-Saharan Africa (SSA).

Methods: We searched MEDLINE and EMBASE databases from 1 January 1996 to 10 October 2017 for studies reporting on the prevalence, aetiologies, treatment and prognosis of HF in SSA. Screening of titles and abstracts, full texts, and data extraction was independently done by two authors. Data was summarised narratively and using meta-analysis. The ‘meta’ package of the R software was used for meta-analysis. Study-specific prevalence estimates were pooled using a random-effect meta-analysis after stabiising the variance using the Freeman-Tukey arcsine transformation. Publication bias was assessed using the Egger's test. Due to limited word count, only data on the aetiologies of HF will be presented here.

Results: Thirty five full text articles were selected after screening of an initial 3785 titles and abstract. Hypertensive heart disease (HHD) (39.2% [95% CI = 32.6–45.9]) was the commonest cause of HF in SSA, followed by cardiomyopathies (CMO) (21.4% [95% CI = 16.0–27.2]) and rheumatic heart disease (RHD) (14.1% [95% CI = 10.0–18.8]). Ischemic heart disease (7.2% [95% CI = 4.1–11.0]) was rare.

Conclusion: HHD, CMO and RHD are the most common causes of HF in SSA, with HHD and CMO responsible for over 50% of the cases. Also, the last two decades have witnessed a remarkable drop in the prevalence of RHD below 15.0%.

1Medicine and Specialty Ibal Sub-divisional Hospital Cameroon

2Internal Medicine and Specialties University of Yaoundé 1 Cameroon

3Medicine University of Cape Town and Groote Schuur Hospital, Cape Town South Africa

4Internal Medicine and Specialties University of Yaoundé 1 Cameroon

5Medicine University of Paris Sud XI, Le Kremlin-Bicêtre France

6Medicine University of Cape Town and Groote Schuur Hospital, Cape Town South Africa

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