Risk Factors and Prevalence of Dilated Cardiomyopathy in Sub-Saharan Africa: A Systematic Review

Fundikira, Lulu; Chillo, Pilly; Mutagaywa, Reuben; Kamuhabwa, Appolinary; Kwesigabo, Gideon; Asselbergs, Folkert W.; Laake, Linda W. van

doi:10.5334/gh.1166

Cited by 4 publications

(2 citation statements)

References 47 publications

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“…Over the past 50 years, the prevalence of DCM in some regions of the African continent has greatly increased from 10 to 17% ( 96 ) to approximately 35% of all cardiac diseases ( 98 ). An ongoing systematic review on risk factors and prevalence of DCM in SSA will give an insight on the possible factors underlying these trends ( 99 ).…”

Section: Overview Of Cardiovascular Pathologies In Africamentioning

confidence: 99%

Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja

Nakagaayi

Aliku

et al. 2022

Front. Cardiovasc. Med.

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In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epidemiological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseases- leading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality.

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Section: Overview Of Cardiovascular Pathologies In Africamentioning

confidence: 99%

Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja

Nakagaayi

Aliku

et al. 2022

Front. Cardiovasc. Med.

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“…Contrary to high-income countries where ischemic heart disease constitutes the major cause of cardiovascular mortality, in Africa, non-ischemic causes such as hypertension with its complications are currently the leading cause of heart failure [4,5]. A systematic review involving sub-Saharan Africa (SSA) countries reports that hypertension is a key modifiable risk factor in heart failure in general as well as in cardiomyopathies [6]. There is a higher prevalence of hypertension in SSA compared to high-income countries [5].…”

Section: Introductionmentioning

confidence: 99%

Characterization of Non-Ischemic Dilated Cardiomyopathy in a Native Tanzanian Cohort: MOYO Study

Fundikira,

Chillo,

Alimohamed

et al. 2024

Global Heart

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Background: Non-ischemic dilated cardiomyopathy (NIDCM) is a common cause of heart failure with progressive tendency. The disease occurs in one in every 2,500 individuals in the developed world, with high morbidity and mortality. However, detailed data on the role of NIDCM in heart failure in Tanzania is lacking. Aim:To characterize NIDCM in a Tanzanian cohort with respect to demographics, clinical profile, imaging findings and management.Methods: Characterization of non-ischemic dilated cardioMyOpathY in a native Tanzanian cOhort (MOYO) is a prospective cohort study of NIDCM patients seen at the Jakaya Kikwete Cardiac Institute. Patients aged ≥18 years with a clinical diagnosis of heart failure, an ejection fraction of ≤45% on echocardiography and no evidence of ischemia were enrolled. Clinical data, echocardiography, electrocardiography (ECG), coronary angiography and stress ECG information were collected from February 2020 to March 2022. Results:Of 402 patients, n = 220 (54.7%) were males with a median (IQR) age of 55.0 (41.0, 66.0) years. Causes of NIDCM were presumably hypertensive n = 218 (54.2%), idiopathic n = 116 (28.9%), PPCM n = 45 (11.2%), alcoholic n = 10 (2.5%) and other causes n = 13 (3.2%). The most common presenting symptoms were dyspnea n = 342 (85.1%), with the majority of patients presenting with New York Heart Association (NYHA) Class III n = 195 (48.5%). The mean (SD) left ventricular ejection fraction (LVEF) was 29.4% (±7.7), and severe systolic dysfunction (LVEF <30%) was common n = 208 (51.7%). Compared with other forms of DCM, idiopathic DCM patients were significantly younger, had more advanced NYHA class (p < 0.001) and presented more often with left bundle branch block on ECG (p = 0.0042). There was suboptimal use of novel guidelines recommended medications ARNI n = 10 (2.5%) and SGLT2 2-inhibitors n = 2 (0.5%). Conclusions:In our Tanzanian cohort, the majority of patients with NIDCM have an identified underlying cause, and they present at late stages of the disease. Patients with idiopathic DCM are younger with more severe disease compared to other forms of NIDCM.

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Comprehensive analysis of clinical characteristics, management and prognosis in patients with dilated cardiomyopathy discharged from Spanish hospitals.

Esteban-Fernández,

Anguita-Sánchez,

Rosillo

et al. 2024

Hellenic Journal of Cardiology

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Risk Factors and Prevalence of Dilated Cardiomyopathy in Sub-Saharan Africa: A Systematic Review

Abstract: All full-text articles from observational studies (cross-sectional, cohort, retrospective, or prospective) that met the search criteria, published in the English language from January 1, 2000 to December 31, 2020, were included in this review.

Cited by 4 publications

References 47 publications

Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Characterization of Non-Ischemic Dilated Cardiomyopathy in a Native Tanzanian Cohort: MOYO Study

Comprehensive analysis of clinical characteristics, management and prognosis in patients with dilated cardiomyopathy discharged from Spanish hospitals.

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