JMIR Publications

ABSTRACT

Background:

Cardiomyopathies, defined as diseases involving mainly the heart muscle, are linked to 5.9 of 100,000 of estimated mortality of the global population although underdiagnosis is significant. In sub Saharan Africa, studies show that cardiomyopathy constitutes 21.4% of cases with heart failure and comes second only to hypertensive heart disease. However, there is paucity of data in the region regarding the different types of cardiomyopathies. It has been noted that presence of non-modifiable cardiovascular risk factors such as family history, age, ethnicity, gender as well as modifiable risk factors such as hypertension, diabetes, tobacco use, physical inactivity, poor nutrition, excessive alcohol consumption, high cholesterol and obesity increase the probability of developing cardiovascular disease.

Objective:

The review will focus on available literature in sub- Saharan Africa on prevalence of dilated cardiomyopathy (DCM) and associated risk factors in patients with DCM. It will identify gaps in knowledge regarding DCM and establish a foundation for preventive measures through reduction of the risk factors. This will be the first review that focuses solely on DCM while updating available data from previous reviews on cardiomyopathies in sub Saharan Africa.

Methods:

The review will consider all studies, qualitative and quantitative, which involve patients with a diagnosis of dilated cardiomyopathy as well as risk factors encountered in such patients in sub Saharan Africa. Both hospital based and community based studies will be included. Indexed articles in Medline and Embase will be searched. Full copies of articles identified by the search, and considered to meet the inclusion criteria, based on their title, abstract and subject descriptors, will be obtained for data synthesis. Bibliographic searches will also be considered for data collection based on their titles. The collected data will be organized in Mendeley reference manager and later on uploaded to Rayyan web application for systematic reviews articles to allow adequate sorting. Two reviewers will independently select articles against the inclusion criteria. Discrepancies in reviewer selections will be resolved by a third author (arbitrator) prior to selected articles being retrieved.

Results:

Interventions to be documented will include those related to screening and control of risk factors that may lead to DCM, and presence of assessment strategies in patients suspected with DCM. The primary outcome will be the number of cases with different etiologies of DCM. Secondary outcomes will be the number of hospitalizations, mortality due to heart failure, incidence of sudden cardiac death, proportion of participants on heart failure medications, proportion of participants with implantable cardioverter defibrillator placements, number of cases with left ventricular assist device and number of heart transplants in patients with DCM.

Conclusions:

The review will give an update on the status of DCM in sub Sahara Africa and identify gaps that need to be addressed in order to improve preventive measures as well as management of this condition.