Echocardiographic predictors of outcome in acute heart failure patients in sub-Saharan Africa: insights from THESUS-HF

Sani, Mahmoud U; Davison, Beth A.; Cotter, Gad; Damasceno, Albertino; Mayosi, Bongani M.; Mondo, Charles; Dzudie, Anastase; Ojji, Dike; Kouam, Charles Kouam; Suliman, Ahmed; Yonga, Gerald; Ba, Sergine Abdou; Maru, Fikru; Bekele, Alemayehu; Edwards, Christopher; Sliwa, Karen

doi:10.5830/cvja-2016-070

Cited by 10 publications

(7 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All discrepancies the selection of studies were resolved through discussion or with the arbitrage of a third investigator. A total of 35 studies were included in this review [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] . A summary of the selection process is presented in the Fig.…”

Section: Experimental Design Materials and Methodsmentioning

confidence: 99%

Data on the epidemiology of heart failure in Sub-Saharan Africa

Nyaga

Bigna

Agbor³

et al. 2018

Data in Brief

View full text Add to dashboard Cite

In Sub-Saharan Africa (SSA), chronic non-communicable diseases and cardiovascular diseases in particular, are progressively taking over infectious diseases as the leading cause of morbidity and mortality. Heart failure is a major public health problem in the region. We summarize here available data on the prevalence, aetiologies, treatment, rates and predictors of mortality due to heart failure in SSA.

show abstract

Section: Experimental Design Materials and Methodsmentioning

confidence: 99%

Data on the epidemiology of heart failure in Sub-Saharan Africa

Nyaga

Bigna

Agbor³

et al. 2018

Data in Brief

View full text Add to dashboard Cite

show abstract

“…Left atrial size among other clinical variables predicts rehospitalisation or death within 60 days. Left ventricular posterior wall added to clinical variables predicts 180-day mortality rates [219]. The recently described mid-range ejection fraction has not been fully described in Africa.…”

Section: Echocardiographymentioning

confidence: 99%

Heart Failure in Sub-Saharan Africa

Adebiyi¹,

Sliwa‐Hähnle²

2019

Topics in Heart Failure Management

View full text Add to dashboard Cite

Sub-Saharan Africa (SSA) is currently experiencing multiple burden of disease as a result of demographic and epidemiologic transition. This is occasioned rapid urbanization, unhealthy diets rich in fats and salt, western lifestyle and sedentary living. Heart failure (HF) has become a global public health issue. It is associated with high morbidity and mortality, frequent hospitalization and high economic cost. In SSA, HF is a disease of young and middle-aged adults with the attendant high disability-adjusted life years. This is unlike to the clinical profile and pattern of HF in high-income countries of North America, Western Europe and Japan where HF is a disease of the elderly. In addition, while ischaemic heart disease is the commonest aetiologic risk factor for HF in high income countries, HF in SSA is essentially non-ischaemic in origin. Hypertensive heart failure, dilated cardiomyopathy, rheumatic heart disease, pericardial diseases and HIV associated cardiomyopathy are the common risk factors. The chapter reviews the contemporary information on HF in SSA in terms of socio-demographic features, clinical characteristics, aetiological risk factors, management, prognosis and economic burden.

show abstract

“…Our clinical findings highlight the case burden of cardiovascular disease seen in a referral clinic in Sub-Saharan Africa. Hypertensive disease, RHD, and dilated cardiomyopathies account for over 75% of cases of heart failure in Africa [9,23]. Congenital heart defects are also an important cause of morbidity and mortality in the young, especially in children under 5 years of age [24,25].…”

Section: Discussionmentioning

confidence: 99%

Establishment of a cardiac telehealth program to support cardiovascular diagnosis and care in a remote, resource-poor setting in Uganda

et al. 2021

View full text Add to dashboard Cite

Introduction To address workforce shortages and expand access to care, we developed a telemedicine program incorporating existing infrastructure for delivery of cardiovascular care in Gulu, Northern Uganda. Our study had three objectives: 1) assess feasibility and clinical impact 2) evaluate patient/parent satisfaction and 3) estimate costs. Methods All cardiology clinic visits during a two-year study period were included. All patients received an electrocardiogram and echocardiogram performed by a local nurse in Gulu which were stored and transmitted to the Uganda Heart Institute in the capital of Kampala for remote consultation by a cardiologist. Results were relayed to patients/families following cardiologist interpretation. The following telemedicine process was utilized: 1) clinical intake by nurse in Gulu; 2) ECG and echocardiography acquisition in Gulu; 3) echocardiography transmission to the Uganda Heart Institute in Kampala, Uganda; 4) remote telemedicine consultation by cardiologists in Kampala; and 5) communication of results to patients/families in Gulu. Clinical care and technical aspects were tracked. Diagnoses and recommendations were analyzed by age groups (0–5 years, 6–21 years, 22–50 years and > 50 years). A mixed methods approach involving interviews and surveys was used to assess patient satisfaction. Healthcare sector costs of telemedicine-based cardiovascular care were estimated using time-driven activity-based costing. Results Normal studies made up 47%, 55%, 76% and 45% of 1,324 patients in the four age groups from youngest to oldest. Valvular heart disease (predominantly rheumatic heart disease) was the most common diagnosis in the older three age groups. Medications were prescribed to 31%, 31%, 24%, and 48% of patients in the four age groups. The median time for consultation was 7 days. A thematic analysis of focus group transcripts displayed an overall acceptance and appreciation for telemedicine, citing cost- and time-saving benefits. The cost of telemedicine was $29.48/visit. Conclusions Our data show that transmission and interpretation of echocardiograms from a remote clinic in northern Uganda is feasible, serves a population with a high burden of heart disease, has a significant impact on patient care, is favorably received by patients, and can be delivered at low cost. Further study is needed to better assess the impact relative to existing standards of care and cost effectiveness.

show abstract

Echocardiographic predictors of outcome in acute heart failure patients in sub-Saharan Africa: insights from THESUS-HF

Cited by 10 publications

References 34 publications

Data on the epidemiology of heart failure in Sub-Saharan Africa

Data on the epidemiology of heart failure in Sub-Saharan Africa

Heart Failure in Sub-Saharan Africa

Establishment of a cardiac telehealth program to support cardiovascular diagnosis and care in a remote, resource-poor setting in Uganda

Contact Info

Product

Resources

About