Key result
Among 2,418 adult emergency admissions in Tanzania, heart failure (12.2%) and stroke (8.4%) were the most common cardiovascular diagnoses, while acute coronary syndrome was rare (0.3%).
Why the study?
Cardiovascular disease prevalence in sub-Saharan Africa is growing, but the relative burden of ACS, heart failure, and stroke on emergency departments and hospital admissions remains poorly understood.
Observational (n=2,418)
No
In a Tanzanian tertiary center, heart failure and stroke represent a substantial and growing burden of emergency admissions, whereas acute coronary syndrome remains rare, highlighting a distinct cardiovascular disease phenotype in this region.
Substantial HF and stroke burden in Tanzanian EDs warrants resource planning; leaves open drivers of rising stroke admissions for prospective study.
INTRODUCTION: The prevalence of cardiovascular disease in sub-Saharan Africa is substantial and growing. Much remains to be learned about the relative burden of acute coronary syndrome (ACS), heart failure, and stroke on emergency departments and hospital admissions. METHODS: A retrospective chart review of admissions from September 2017 through March 2018 was conducted at the emergency department of a tertiary care center in northern Tanzania. Stroke admission volume was compared to previously published data from the same hospital and adjusted for population growth. RESULTS: Of 2418 adult admissions, heart failure and stroke were the two most common admission diagnoses, accounting for 294 (12.2%) and 204 (8.4%) admissions, respectively. ACS was uncommon, accounting for 9 (0.3%) admissions. Of patients admitted for heart failure, uncontrolled hypertension was the most commonly identified etiology of heart failure, cited in 124 (42.2%) cases. Ischemic heart disease was cited as the etiology in only 1 (0.3%) case. Adjusting for population growth, the annual volume of stroke admissions increased 70-fold in 43 years, from 2.9 admissions per 100,000 population in 1974 to 202.2 admissions per 100,000 in 2017. CONCLUSIONS: The burden of heart failure and stroke on hospital admissions in Tanzania is substantial, and the volume of stroke admissions is rising precipitously. ACS is a rare diagnosis, and the distribution of cardiovascular disease phenotypes in Tanzania differs from what has been observed outside of Africa. Further research is needed to ascertain the reasons for these differences.
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Hertz et al. (2019) conducted an observational in Acute coronary syndrome, heart failure, and stroke (n=2,418). Cardiovascular disease (heart failure, stroke, ACS) was evaluated on Admission diagnosis frequency. Among 2,418 adult emergency admissions in Tanzania, heart failure (12.2%) and stroke (8.4%) were the most common cardiovascular diagnoses, while acute coronary syndrome was rare (0.3%).
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