What is the clinical evidence from this study?

Study design: Observational. Population: Cardiovascular disease (n=4945). Primary outcome: in-hospital mortality.

What does this research mean for the field?

Heart failure was the most common cause of admission (42%) among 4945 patients in Sub-Saharan Africa, with an overall in-hospital mortality rate of 11%. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to describe causes of hospital admission for cardiovascular disease and the associated outcomes in Sub-Saharan Africa.

February 6, 2026

Trends in cardiology admissions and mortality across 37 hospitalization departments in Sub-Saharan Africa: The FEBRUARY study (2016-2023)

Key Result

Among 4945 cardiology admissions in 17 Sub-Saharan African countries, heart failure was the leading cause (42%), and overall in-hospital mortality was 11%, varying significantly by wealth index.

Key Points

The aim is to describe causes of hospital admission for cardiovascular disease and the associated outcomes in Sub-Saharan Africa.
Conducted a transversal and longitudinal study in cardiology departments of 37 hospitals across 17 countries
Collected socio-demographic and clinical data on all inpatients during February each year from 2016 to 2023
Analyzed data using R software for detailed statistical assessment
Included 4945 patients over eight years, with a mean age of 56.6 years and 56.1% being men
Heart failure was the leading cause of admission at 42%, with stroke and acute coronary syndrome following
In-hospital mortality rate was 11%, with variations depending on cause of admission and patient wealth index

Study Design

Type

Observational (n=4,945)

Multicenter

Yes

Structured PICO

Population

4,945 inpatients admitted to cardiovascular departments in February from 2016 to 2023 across 37 hospitals in 17 Sub-Saharan African countries. Mean age 56.6, 56.1% men.

Outcome

Causes of admission for CVD and outcome of hospitalization (in-hospital mortality)hard clinical

Heart failure is the leading cause of cardiovascular admission in Sub-Saharan Africa, with an overall in-hospital mortality of 11% that is significantly higher among patients with a low wealth index.

Abstract

Abstract Background Cardiovascular disease is a leading cause of mortality worldwide. At least two-third of CVD death occurs in low- (LIC) and middle-income(MIC) countries. Recent studies estimate that CVD are responsible for 13% of all deaths in Sub-Saharan Africa(SSA). Scarce data are available about the admission to hospital for CVD and outcome in cardiology department in SSA. Purpose To describe causes of admission for CVD and outcome of hospitalization in 17 in SSA countries. Methods We conducted a transversal and longitudinal study in CV department of 37 hospitals from 23 cities in 17 SSA countries (10 low income: Niger, Guinea, Benin, Mali, Democratic Republic of the Congo, Tchad, Burkina Faso, Togo, Burundi, Ethiopia and 7 middle income: Cote d’Ivoire, Senegal, Cameroon, Congo, Soudan, Mauritania, Gabon). The February study was designed by a multidisciplinary collaborative team of epidemiologists, pharmacists and cardiologists from Africa and France. This ongoing observatory included all inpatients in February from each year since 2016. Data including socio-demographic and clinical characteristics, causes of admission, clinical, biological, complementary examinations, treatments, length of stay and discharge diagnosis were collected by the investigating physicians. All analyses were performed through scripts developed in the R software (4.0.3(2020-10-10)) Results Overall, 4945 patients were included over the 8 years of the study. Men represented 56.1%. Mean of age was 56.6 ± 16.9 years. The main cause of admission was heart failure (42%) followed by acute coronary syndrome (12%) and stroke (11%). Cause of admission varied significantly across countries (p0.01) and over the years (p0.01). Proportions of admission for heart failure varied from 28% in Democratic Republic of the Congo to 75% in Guinea. Mean of length of stay was 9.8±22days. All causes of admission confounded, in-hospital mortality rate was 11% (N=471). Hospital mortality rate differed significantly according to causes of admission (p0.01).Mortality rate among patients admitted for stroke, heart failure and acute coronary syndrome was respectively 18.5%, 12.2% and 8.8%. Overall, 32 (0.7%) were admitted for endocarditis and mortality rate among them was 20.8% (figure). Overall, mortality rate did not vary according to gender or level-income countries but was significantly different over the years; according to countries (p0.01) and to patient wealth index (p0.05). Mortality rate was significantly higher in patient with low wealth index. Conclusion Our study describes the causes of admission and the associated in-hospital mortality rate over an eight-year period in 17 sub-Saharan African (SSA) countries. We identified several disparities related to the causes of admission and income levels. Inequities in access to care remain a barrier to reducing the burden of cardiovascular disease (CVD) in Africa.

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