Study protocol: systematic review of the burden of heart failure in low- and middle-income countries

Abstract

BackgroundSetting priorities for the prevention and management of heart failure requires an empirical understanding of the pattern of disease burden. We aim to describe the methods for a systematic review of the literature on burden of heart failure in low- and middle-income countries (LMIC) and how this information will be synthesized to produce useful estimates that can inform policy and practice.MethodsWe will conduct a comprehensive search strategy for articles published between 1995 and April 2012 related to incidence, prevalence and treatment of heart failure in LMIC. Populations will be coded as urban, rural, or combined and studies classified as national, sub-national, healthcare system-based, or community level. Details from eligible studies will be extracted independently by two reviewers using a pre-designed data extraction form that will cover information on demographics, diagnostic criteria including disease incidence and prevalence, medical history, medication history, and hospital- or community-based management and outcomes. We will assess the reporting and methodological quality of the included studies and conduct a quantitative summary of reported outcomes where appropriate.DiscussionCurrently, there are important gaps in our knowledge on the burden of heart failure in LMIC and this systematic review aims to provide useful information that improves our knowledge in this field. Results are expected to be publicly available in early 2013.

Mortality from heart failure, acute myocardial infarction and other ischaemic heart disease in England and Oxford: a trend study of multiple-cause-coded death certification

“…This suggests that the burden of heart failure within low-income and middle-income countries may actually increase substantially over the next 20 years. 20 Even in the UK, despite the observed improvements in mortality for cardiac disease, mortality for IHD is still higher than in many European countries and Australia. Recent findings of the global burden of disease study 2010 show that the UK ranked 17/19 against comparator nations on mortality for IHD in 1990, improving only to 14/19 in 2010, 17 and control of hypertension as the major risk factors for IHD and HF is not optimal.…”

Heart Failure Care in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

“…This systematic review was designed and undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [13] . A study protocol describing the methodology has been published previously [14] . In brief, we searched Medline, Embase, Global Health Database, and WHO regional databases for articles published between 1 January 1995 and 30 March 2014 with the subject terms “heart failure” or “cardiomyopathies” or any related terms AND “incidence”, “prevalence”, “cause*”, “etiology”, “aetiology”, “epidemiolog*”, “burden”, “management”, “treatment”, “prevent*”, “population based”, “community”, “trends”, “survey”, “surveillance”, “mortality”, “morbidity”, “fatalit*”, or “attack rate”.…”

Epidemiology and aetiology of heart failure

“…Although reliable estimates for middle-income and low-income nations are lacking, evidence from the current literature suggests that HF is the fastest growing cardiovascular condition globally 61,62 . Of the 1.63 billion people who live in South Asia, 30 million would have had HF in 2011, if the prevalence of HF in South Asia is assumed to be the same as that in the USA 63 .…”