Quality of Life in Patients with Chronic Heath Failure Followed at the Tertiary Hospitals of Sub-Saharan Africa

Abstract

Heart Failure (HF) has become one of the most important chronic medical conditions worldwide. It's associated with high morbidity and mortality. Despite improving in patient's management, little works have been done to evaluate the quality of life of patients with heart failure in Sub-Saharan Africa. The objective of this work was to assess the quality of life of patients with Chronic Heart Failure (CHF) followed in three reference hospitals of Cameroon. We carried out a crosssectional study over a period of 04 months, from January to May 2017. The patients were recruited from the cardiology departments of three references Hospitals of Cameroon: Yaoundé Central Hospital (YCH), General Hospital of Yaoundé (GHY) and Yaoundé University Teaching Hospital (YUTH). We included all patients aged 18 years and above followed for CHF and consenting to participate in the study. Patients with other chronic conditions (chronic kidney disease, cancer, schizophrenia) were excluded. The quality of life was assessed using the Minnesota Living with Heart Failure tool (MLwHF). A total of 119 patients were recruited. The mean age was 66 ± 13 years. More than 2/3 (70.6%) of the patients were unemployed. The majority of patients (83.2%) had low monthly income (< 100 000 FCFA). Stage II of heart failure according to New York Heart Association (NYHA) was the most represented (50 %). The median scores for the Minnesota Living with Heart Failure Questionnaire (MLwHFQ) were generally low. The risk factors of poor life quality were: young age (p = 0.039), low educational attainment (p = 0.046), low monthly income (p = 0.024), exposure to tobacco (p = 0.005), low left ventricular ejection fraction (p = 0.003), mental depression (p < 0.001), anxiety (p < 0.001), non-adherence to treatment (p = 0.035). The only factors that remain significant after adjusting for confounders are: mental depression (0, 002) and functional class of NYHA (< 0, 001). In conclusion, Quality of life is slightly affected in patients with chronic heath failure. The few proportion of alter quality of life is explained mostly by psychological and clinical factors. The clinician should pay attention to these factors for the better management of the patients in Sub-Saharan Africa.