Epidemiology of pericardial diseases in Africa: a systematic scoping review

Abstract

ObjectivesThis scoping review sought to summarise available data on the prevalence, aetiology, diagnosis, treatment and outcome of pericardial disease in Africa.MethodsWe searched PubMed, Scopus and African Journals Online from 1 January 1967 to 30 July 2017 to identify all studies published on the prevalence, aetiologies, diagnosis, treatment and outcomes of pericardial diseases in adults residing in Africa.Results36 studies were included. The prevalence of pericardial diseases varies widely according to the population of interest: about 1.1% among people with cardiac complaints, between 3.3% and 6.8% among two large cohorts of patients with heart failure and up to 46.5% in an HIV-infected population with cardiac symptoms. Tuberculosis is the most frequent cause of pericardial diseases in both HIV-uninfected and HIV-infected populations. Patients with tuberculous pericarditis present mostly with effusive pericarditis (79.5%), effusive constrictive pericarditis (15.1%) and myopericarditis (13%); a large proportion of them (up to 20%) present in cardiac tamponade. The aetiological diagnosis of pericardial diseases is challenging in African resource-limited settings, especially for tuberculous pericarditis for which the diagnosis is not definite in many cases. The outcome of these diseases remains poor, with mortality rates between 18% and 25% despite seemingly appropriate treatment approaches. Mortality is highest among patients with tuberculous pericarditis especially those coinfected with HIV.ConclusionPericardial diseases are a significant cause of morbidity and mortality in Africa, especially in HIV-infected individuals. Tuberculosis is the most frequent cause of pericardial diseases, and it is associated with poor outcomes.

Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

“…In SSA, the most common cause of pericarditis is tuberculosis accounting for about 65-91% of cases of pericardial disease across studies [88][89][90], compared to HIC of western world where about 80% or more of pericardial effusions are idiopathic with tuberculosis accounting for only <5% of cases [91,92]. In a recent systematic review that included 36 studies from SSA, tuberculosis was the most frequent cause of pericardial diseases in both HIV-uninfected and HIV-infected populations, followed by malignancies and rheumatological diseases [88].…”

Hypertension prevalence, associated factors, treatment, and control in rural Cameroon: a cross-sectional study

“…Cardiovascular diseases are the second commonest cause of premature disability and death in sub-Sahara Africa (SSA) [4][5][6]. A greater bulk of the burden of heart disease, kidney failure, stroke and premature death in this region is accounted for by hypertension [7][8][9][10].…”

A Patient Presented with High Fever and Bloody Pericardial Effusion (Hemorrhagic Pericarditis)

“…Despite he was started on isoniazid, rifampin, ethambutol, and pyrazinamide plus B6, he showed improvement but fever continued few more days, moxifloxacin was added and fever resolved. An extensive review on the causes of pericarditis conducted by Noubiap JJ, et al revealed that M. tuberculosisis a responsible agent in pericarditis, but not hemorrhagic pericarditis, and furthermore, no unique 2D-echocardiographic signs were detected [9]. A cross-sectional study from Sudan between January 2011 and June 2012 enrolled 985 patients, 22.7% (224) were extrapulmonary tuberculosis, only 1.9% [4] patients were pericardial, and none were hemorrhagic [10].…”