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Heart. 2014 Aug;100(16):1235-41. doi: 10.1136/heartjnl-2014-305599. Epub 2014 Apr 17.

Contemporary aetiology, clinical characteristics and prognosis of adults with heart failure observed in a tertiary hospital in Tanzania: the prospective Tanzania Heart Failure (TaHeF) study.

Author information

  • 1Cardiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
  • 2Cardiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
  • 3School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania Cardiovascular Center, Muhimbili National Hospital, Dar es Salaam, Tanzania.
  • 4Cardiovascular Center, Muhimbili National Hospital, Dar es Salaam, Tanzania.
  • 5School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
  • 6Cardiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.

Abstract

OBJECTIVE:

This study aimed to describe the contemporary aetiology, clinical characteristics and mortality and its predictors in heart failure (HF) in Tanzania.

METHODS:

Design; Prospective observational study. Setting; Cardiovascular Center of the Muhimbili National Hospital in Dar es Salaam, Tanzania. Patients ≥18 years of age with HF defined by the Framingham criteria.

MAIN OUTCOME MEASURE:

All-cause mortality.

RESULTS:

Among 427 included patients, 217 (51%) were females and the mean (SD) age was 55 (17) years. HF aetiologies included hypertension (45%), cardiomyopathy (28%), rheumatic heart disease (RHD) (12%) and ischaemic heart disease (9%). Concurrent atrial fibrillation (AF), clinically significant anaemia, diabetes, tuberculosis and HIV were found in 16%, 12%, 12%, 3% and 2%, respectively, while warfarin was used in 3% of the patients. The mortality rate, 22.4 per 100 person-years over a median follow-up of 7 months, was independently associated with AF, HR 3.4 (95% CI 1.6 to 7.0); in-patient 3.2 (1.5 to 6.8); anaemia 2.3 (1.2 to 4.5); pulmonary hypertension 2.1 (1.1 to 4.2) creatinine clearance 0.98 (0.97 to 1.00) and lack of education 2.3 (1.3 to 4.2).

CONCLUSIONS:

In HF in Tanzania, patients are younger than in the developed world, but aetiologies are becoming more similar, with hypertension becoming more and RHD less important. Predictors of mortality possible to intervene against are anaemia, AF and lack of education.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PMID:
24743164
[PubMed - indexed for MEDLINE]
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