Table 1
General aspects of the studies on HF patients in SSA.
| VARIABLE | NUMBER OF STUDIES | VALUE |
|---|---|---|
| Mean Age, mean(SD) | 21 | 52.5(6.2) |
| Male sex, median(IQR) | 21 | 44.2(33.2–49.5) |
| DCM prevalence, median(IQR) | 14 | 20.5(9.7–31.7) |
| Idiopathic DCM prevalence, median(IQR) | 11 | 13.8(11.0–19.6) |
| Study type, n (%) | 24 | |
| Cross sectional | 7(29.2%) | |
| Prospective | 10(41.7%) | |
| Retrospective | 7(29.2%) | |
| Country, n (%) | 24 | |
| Nigeria | 6(25%) | |
| Tanzania | 4(16.7%) | |
| Uganda | 2(8.3%) | |
| Ghana | 2(8.3%) | |
| Others | 9(37.8%) | |
| SSA* | 1(4.2%) | |
| Quality assessment of studies, n (%) | 24 | |
| Good | 8(33.3) | |
| Fair | 15(62.5) | |
| Poor | 1(4.2) |
[i] * This study involved 9 countries in SAA namely Sudan, Ethiopia, Kenya, Uganda, Mozambique, South Africa, Cameroon, Nigeria and Senegal.
Table 2
DCM prevalence in patients with heart failure in Sub-Saharan Africa.
| FIRST NAME AUTHOR, YEAR PUBLISHED | COUNTRY | STUDY DESIGN | STUDY SETTING | SAMPLE SIZE | MALE (%) | MEAN AGE (YEARS) | DCM PREVALENCE % | IDIOPATHIC DCM PREVALENCE % | CRITERIA FOR IDIOPATHIC DCM DIAGNOSIS |
|---|---|---|---|---|---|---|---|---|---|
| A G B Amoah, 2000 [37] | Ghana | Cross sectional | Hospital based | 572 | NR | 42.3 | NR | 16.8 | Stated as idiopathic DCM in the article |
| K Sliwa et al, 2008 [38] | South Africa | Prospective | Hospital based | 844 | NR | NR | NR | 35.0 | ESC guidelines |
| K Karaye, 2008 [39] | Nigeria | Cross sectional | Hospital based | 76 | 55.7 | 46.9 | 10.1 | NR | |
| D B Ojji, 2009 [40] | Nigeria | Cross sectional | Hospital based | 340 | 50.9 | 50.6 | NR | 13.8 | Idiopathic DCM the left ventricle was dilated (with or without dilatation of the other three cardiac chambers) with global systolic and diastolic dysfunctions in subjects with no known cause of heart failure |
| O Onwuchewka, 2009 [41] | Nigeria | Cross sectional | Hospital based | 423 | 57.2 | 54.4 | 7.3 | NR | |
| A Damasceno, 2012 [8] | SSA | Cross sectional | Hospital based | 1006 | 49.2 | 52.3 | NR | 18.8 | ESC guidelines |
| GF Kwan, 2013 [42] | Rwanda | Retrospective | Hospital based | 138 | 27.0 | 35.0 | 54.0 | NR | |
| D B Ojji, 2013 [43] | Nigeria | Prospective | Hospital based | 1515 | 49.3 | 49.0 | NR | 12.0 | The diagnosis was that of exclusion in subjects presenting with features of heart failure without any obvious etiological factor |
| S Okello, 2014 [44] | Uganda | Retrospective | Hospital based | 274 | 30.3 | 52.0 | 31.4 | NR | |
| A Makubi, 2014 [45] | Tanzania | Prospective | Hospital based | 427 | 45.0 | 55.0 | 21.1 | NR | |
| O S Ogah, 2014 [28] | Nigeria | Prospective | Hospital based | 452 | 54.9 | 56.6 | 7.5 | NR | |
| T B Abebe, 2016 [46] | Ethiopia | Retrospective | Hospital based | 311 | 23.8 | 53.5 | NR | 12.5 | Idiopathic DCM when there was no other known cardiac cause and had LVEF <50% |
| G S Bloomfield, 2016 [47] | Kenya | Prospective case-control study | Hospital based | 118 | 49.0 | 61.0 | 19.5 | NR | |
| K O Bonsu, 2017 [48] | Ghana | Retrospective | Hospital based | 1488 | 46.6 | 60.3 | 19.9 | NR | |
| J T Hertz, 2017 [49] | Tanzania | Retrospective | Hospital based | 294 | 44.2 | 62.4 | 8.5 | NR | |
| J C Mwita, 2017 [29] | Botswana | Cross sectional | Hospital based | 193 | 53.9 | 54.2 | NR | 19.6 | ESC and study of Soweto Guidelines |
| S Mmbali, 2017 [50] | Tanzania | Prospective | Hospital based | 131 | 43.5 | 45.3 | 32.8 | NR | |
| S Okello, 2018 [51] | Uganda | Prospective | Hospital and community | 195 | 32.0 | 52.0 | 20.0 | NR | |
| D Malamba-Les, 2018 [23] | DRC | Retrospective | Hospital based | 231 | 47.0 | 56 | 47.6 | NR | |
| M M Baba, 2018 [52] | Nigeria | Prospective | Hospital based | 354 | 36.6 | 46.9 | NR | 11.0 | Stated as idiopathic DCM in the article |
| C Nkoke, 2019 [53] | Cameroon | Cross sectional | Hospital based | 86 | 44.5 | 59.4 | NR | 9.3 | Stated as idiopathic DCM in the article |
| N Madjirangar, 2019 [54] | Chad | Retrospective | Hospital based | 100 | 52.0 | 40.2 | 22.0 | 8.0 | Stated as idiopathic DCM in the article |
| P Pallangyo, 2020 [55] | Tanzania | Prospective | Hospital based | 419 | 43.4 | 46.4 | 27.0 | NR |
[i] NR = Not recorded.
Table 3
Cardiovascular risk factors in HF patients studied in SSA.
| VARIABLE | NUMBER OF STUDIES | VALUE |
|---|---|---|
| Age in years, mean (SD) | 21 | 52.5(6.2) |
| Hypertension %, median(IQR) | 23 | 53.4(35.9–59.0) |
| Male sex %, median(IQR) | 21 | 44.2(33.2–49.5) |
| Diabetes Mellitus %, median(IQR) | 17 | 11(1.9–12.8) |
| Tobacco use %, median(IQR) | 10 | 6.6(2.5–19.1) |
| Physical inactivity % | 1 | 73% |
| Poor Nutrition % | 0 | 0 |
| Excessive alcohol intake %, median(IQR) | 7 | 10(2.1–16.0) |
| High cholesterol/Dyslipidemia %; median(IQR) | 4 | 6.6(2.5–9.1) |
| Obesity %, median (IQR) | 6 | 20.6(11.2–33.5) |
| Family history %, mean (SD) | 2 | 4.0(0.9) |
| Ethnicity(blacks),median(IQR) | 3 | 98.4(94.3–99.6) |
| BMI, median (IQR) | 5 | 25.1(22.7–26.8) |
| Low level of education %, median(IQR) | 6 | 34.9(3.1–38) |