Valirie N. Agbor¹, Mickael Essouma², Ntobeko A.B. Ntusi^3,4,5, Ulrich Flore Nyaga², Jean Joel Bigna⁶, Jean Jacques Noubiap^3*

Authors’ affiliations

1. Ibal Sub-divisional Hospital, Oku, North-west Region, Cameroon;
2. Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon;
3. Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa;
4. Cape Universities Body Imaging Center, University of Cape Town, Cape Town, South Africa;
5. Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa
6. Faculty of Medicine, University of Paris Sud XI, Le Kremlin-Bicêtre, France

Corresponding author : Dr Jean Jacques N. Noubiap, Department of Medicine, University of Cape Town and Groote Schuur Hospital, 7925 Observatory, Cape Town, South Africa. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Objectives: To summarise available data on the prevalence, aetiology, treatment, prognosis and cost of treatment of heart failure (HF) in sub-Saharan Africa (SSA).

Setting: This systematic review and meta-analysis recruited participants from every health facility in SSA.

Participants: All published literatures between January 1, 1996 to May 31, 2017, of individuals aged 12 years and older and residing in sub-Saharan Africa. They must be of African descent.

Outcome: Number of HF admissions in to general wards and HF clinics; number of cases of the different aetiologies of HF; number of participants on the different medications for HF; number of cases of all-cause mortality in participants with HF, and the predictors of all-cause mortality; cost of treatment for HF on the individual patient. Due to a limited word count, only results on the aetiologies of HF will be presented in the abstract.

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%.

Keywords: Heart failure, epidemiology, aetiologies, treatment, prognosis, cost, sub-Saharan Africa.