Epidemiology of heart failure in Niger: a retrospective study (January 2019 - December 2025)

Introduction Heart failure represents a major public health challenge in Niger, contributing significantly to morbidity and mortality. Understanding its epidemiology is essential for planning effective prevention and management strategies. This study aimed to describe the epidemiological profile of heart failure patients in Niger, focusing on main causes, comorbidities, and outcomes. Objective To determine the prevalence, etiologies, comorbidities, and outcomes of heart failure in Niger between January 2019 and December 2025. Methods A retrospective analysis was conducted on data from 4,386 patients diagnosed with heart failure in Niger over a seven-year period (January 2019 to December 2025). Demographic characteristics, underlying causes, comorbidities, associated infections, and mortality rates were analyzed. Results Among the 4,386 patients included, 52% were male and 48% female, with a mean age of 54.2 ± 15.7 years. Heart failure prevalence was 42.8% in the studied population. The leading causes were hypertension (28.6%), cardiomyopathies (21.4%), ischemic heart disease (17.6%), and rheumatic heart disease (12.6%). Other less common causes included valvular heart diseases and congenital heart defects. Patients frequently presented with multiple comorbidities: physical inactivity (31.6%), dyslipidemia (20.6%), atrial fibrillation (13.6%), diabetes mellitus (9.6%), and prior COVID-19 infection (6.7%). Infectious comorbidities were also prominent, with pulmonary infections in 26.9% (including tuberculosis in 9.6%), malaria in 23.8%, and urinary tract infections in 12.8%. Regarding clinical presentation, 61.2% of patients were classified as NYHA class II–III, while 19.8% were NYHA class IV. Mortality was significant, with 13.8% of patients dying within six months of diagnosis and 18.4% within one year. Hospital readmission rates for heart failure exacerbation were 22.3% over one year. Discussion Hypertension and cardiomyopathies emerged as the leading causes of heart failure in Niger. High rates of comorbidities and infectious diseases suggest the need for integrated management approaches. Physical inactivity and metabolic disorders further contribute to disease burden. Conclusion Heart failure in Niger is associated with substantial morbidity and mortality. Preventive and therapeutic strategies targeting both cardiovascular risk factors and infectious comorbidities are urgently needed to improve patient outcomes.