Heart failure in sub-Saharan Africa: A literature review with emphasis on individuals with diabetes

Introduction: Anemia has been implicated in heart failure. Existing literatures, involving predominantly African-Americans, suggests that Sickle Cell Disease (SCD) maybe linked to various cardiovascular complications including pulmonary hypertension and left venticular dysfunction. Peculiarly, our study involves exclusively Sub-Saharan population. Method: We conducted a cross sectional observational study of 208 hydroxyurea-naive consecutive SCD patients aged 10-52 years at steady state and 94 healthy non-matched controls who were studied in an out patient clinic in Sub-Saharan Africa. SCD patients were required to have electrophoretic or liquid chromatography documentation of major sickling phenotypes. Control group was required to have non-sickling phenotypes. Cardiac measurements were performed with TransThoracic Echo according to American Society of Echocardiography guidelines. Hemoglobin level was also obtained. Results: Hemoglobin level in SCD group (8.5+/- 1.5) was significant (P<0.001) compared to control (13.8+/- 1.7). Although SCD group had significantly higher values of left ventricular (LV) size, there was no qualitative evidence of LV dysfunction. SCD group had higher values of Ejection Fraction but not statistically significant. There was no evidence of LV wall stiffening to impair proper filling in SCD group, with the ratio of early to late ventricular filling velocities, E/A ratio elevated (1.7+/-0.4 compared to 1.6+/- 0.4; P=0.010). Right ventricular systolic pressure was determined using the formula of 4x Tricuspid Reugurgitant jet (TRV) square as an indirect measurement of Pulmonary arterial systolic pressure. SCD patients had significantly higher mean±SD values for tricuspid regurgitant jet velocity than did the controls (2.1±0.6 vs. 1.8±0.5; p= 0.001). Within the SCD group, there was no clear pattern of worsening diastolic function with increased TRV. Furthermore, E/A had a significant positive relationship with jet velocity in bivariate analysis (R=0.20; P=0.013). Conclusions: We were unable to demonstrate existence of anemia-associated left ventricular dysfunction in Sub-Saharan African with SCD. Further studies is required to highlight the reason behind this finding.

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Heart failure in sub-Saharan Africa: A clinical approach

South African Medical Journal ◽

10.7196/samj.2016.v106i1.10325 ◽

2015 ◽

Vol 106 (1) ◽

pp. 23 ◽

Cited By ~ 7

Author(s):

Sarah Kraus ◽

Gboyega Ogunbanjo ◽

Karen Sliwa ◽

Ntobeko A B Ntusi

Keyword(s):

Heart Failure ◽

Sub Saharan Africa ◽

Clinical Approach ◽

Sub Saharan

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Characteristics of patients with acute heart failure in North Central Nigeria

Research Journal of Health Sciences ◽

10.4314/rejhs.v9i3.3 ◽

2021 ◽

Vol 9 (3) ◽

pp. 221-235

Author(s):

J.A. Ogunmodede ◽

P.M. Kolo ◽

M.O. Bojuwoye ◽

B.F. Dele-Ojo ◽

A.J. Ogunmodede ◽

...

Keyword(s):

Heart Failure ◽

New York ◽

Heart Association ◽

Public Health Education ◽

Sub Saharan Africa ◽

Aetiological Factor ◽

Cross Sectional ◽

Early Presentation ◽

North Central ◽

Sub Saharan

Objectives: Heart failure (HF) is an important cause of hospital admission in Nigeria. HF is increasingly prevalent because the population is aging and HF epidemiology is changing. We aimed at profiling the socio-demographic, clinical and echocardiographic (Echo) characteristics of patients admitted for acute HF. This is one of the largest cohorts of HF patients profiled in Nigeria so far. Methods: Cross sectional design. Socio-demographic, clinical and Echo data were collected from 455 patients admitted for AHF at University of Ilorin Teaching Hospital, North central, Nigeria. Results: Mean age of patients was 58.9± 15.7years, (men were older than women, P= 0.006). 265(58.2%) were males, most patients were aged >60 years, 4.8% had pre-existing Type2 Diabetes mellitus. 53.2% of patients presented in New York Heart Association Stages III and IV. Median duration of admission was 11days (IQR, 6-17), intrahospital mortality- 11.6%. Hypertension was the commonest aetiological factor (62.4%), followed by dilated cardiomyopathy 17.6%, rheumatic heart disease (6.6%), Peripartum cardiomyopathy (5.3%), and others. Conclusion: AHF patients in our study are older than those in previous studies in Nigeria and sub-Saharan Africa. Hypertension is main driver of AHF, and patients largely present with clinically advanced disease necessitating stronger public health education about risk factors and early presentation.

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Challenges in the management of cardiovascular emergencies in Sub-Saharan Africa: a case report of acute heart failure complicating infective endocarditis in a semi-urban setting in Cameroon

BMC Research Notes ◽

10.1186/s13104-018-3361-2 ◽

2018 ◽

Vol 11 (1) ◽

Author(s):

Clovis Nkoke ◽

Denis Teuwafeu ◽

Cyrille Nkouonlack ◽

Martin Abanda ◽

Wilfried Kouam ◽

...

Keyword(s):

Heart Failure ◽

Case Report ◽

Infective Endocarditis ◽

Acute Heart Failure ◽

Urban Setting ◽

Sub Saharan Africa ◽

Sub Saharan

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Sultanism

10.1093/oso/9780197586488.003.0004 ◽

2021 ◽

pp. 47-76

Author(s):

Christopher M. Davidson

Keyword(s):

Twentieth Century ◽

Latin America ◽

Middle East ◽

Literature Review ◽

Eastern Europe ◽

Latin American ◽

Max Weber ◽

Sub Saharan Africa ◽

Empirical Literature ◽

Sub Saharan

To facilitate a comprehensive and up-to-date understanding of the concept of sultanism, this chapter provides a detailed theoretical and empirical literature review. Firstly, it considers the oriental origins of the concept, as applied by Max Weber and others to the Ottoman Empire and a number of South Asian examples. Secondly, it traces the emergence of ‘contemporary sultanism’, as applied by scholars to Latin American regimes from the mid-twentieth century and onwards. Thirdly, it explores the more recent concept of neo-sultanism and the development of a distinct international empirical category of autocratic-authoritarianism which includes: various Latin America regimes; some of the former communist republics of central Asia and Eastern Europe; and a number of regimes in sub-Saharan Africa and parts of Southeast Asia. Finally, it assesses the need to address the scholarly deficit in applying contemporary sultanism or neo-sultanism to the Middle East, and suggests that the present-day Saudi And UAE regimes may be strong examples.

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