The Ibadan Acute and Chronic Heart Failure Project

Background and Purpose Heart failure (HF) has emerged a major global public health problem.(1,2) HF affects over 64 million people worldwide. (3) It is a highly symptomatic syndrome that affects 2-3% of the population in high income countries especially in people above the age of 65 years. (4 5) Until recently, little was known about the emerging problem of non-communicable forms of HF supplementing traditional pathways to the syndrome in sub-Saharan Africa due to infections and infestations. Contemporary studies from South Africa (6) and Nigeria (7) have built on historical reports to demonstrate that the aetiology and indeed case profile of acute HF (i.e. more women and younger individuals affected in the prime of their life) is different from high-income countries. As such, HF is now responsible for 7-10% of medical admissions in the region. (7) These are entirely based on studies on acute HF. There are only few data on chronic HF in Africa. Furthermore, the nexus between endemic infections such as tuberculosis (TB) and HIV/AIDS and other non-communicable or non-infectious risk factors and HF in Africa is scarcely documented.

Gaps in knowledge on heart failure in sub-Saharan Africa

1. Co-morbidities in HF patients, which are common and important to outcomes, have not been well studied in large cohorts in sub-Saharan Africa (SSA).
2. The role and co-occurrence of infection such as tuberculosis and HIV /AIDS has not been extensively explored in the region.

4 There is paucity of information on the long-term outcome of HF in SSA (rehospitalization and mortality) 5 Current phenotypes of HF (HFrEF, HFpEF, HFmrEF), their clinical and sociodemographic predictors, management and outcomes are not well described in SSA.

6 There is also paucity of data on the assessment of barriers to HF care in SSA.