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Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study.

Publication ,  Journal Article
Prattipati, S; Sakita, FM; Kweka, GL; Tarimo, TG; Peterson, T; Mmbaga, BT; Thielman, NM; Limkakeng, AT; Bloomfield, GS; Hertz, JT
Published in: PLoS One
2021

BACKGROUND: The burden of heart failure is growing in sub-Saharan Africa, but there is a dearth of data characterizing care and outcomes of heart failure patients in the region, particularly in emergency department settings. METHODS: In a prospective observational study, adult patients presenting with shortness of breath or chest pain to an emergency department in northern Tanzania were consecutively enrolled. Participants with a physician-documented clinical diagnosis of heart failure were included in the present analysis. Standardized questionnaires regarding medical history and medication use were administered at enrollment, and treatments given in the emergency department were recorded. Thirty days after enrollment, a follow-up questionnaire was administered to assess mortality and medication use. Multivariate logistic regression was performed to identify baseline predictors of thirty-day mortality. RESULTS: Of 1020 enrolled participants enrolled from August 2018 through October 2019, 267 patients (26.2%) were diagnosed with heart failure. Of these, 139 (52.1%) reported a prior history of heart failure, 168 (62.9%) had self-reported history of hypertension, and 186 (69.7%) had NYHA Class III or IV heart failure. At baseline, 40 (15.0%) reported taking a diuretic and 67 (25.1%) reported taking any antihypertensive. Thirty days following presentation, 63 (25.4%) participants diagnosed with heart failure had died. Of 185 surviving participants, 16 (8.6%) reported taking a diuretic, 24 (13.0%) reported taking an antihypertensive, and 26 (14.1%) were rehospitalized. Multivariate predictors of thirty-day mortality included self-reported hypertension (OR = 0.42, 95% CI: 0.21-0.86], p = 0.017) and symptomatic leg swelling at presentation (OR = 2.69, 95% CI: 1.35-5.56, p = 0.006). CONCLUSION: In a northern Tanzanian emergency department, heart failure is a common clinical diagnosis, but uptake of evidence-based outpatient therapies is poor and thirty-day mortality is high. Interventions are needed to improve care and outcomes for heart failure patients in the emergency department setting.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2021

Volume

16

Issue

7

Start / End Page

e0254609

Location

United States

Related Subject Headings

  • Tanzania
  • Surveys and Questionnaires
  • Prospective Studies
  • Middle Aged
  • Logistic Models
  • Humans
  • Heart Failure
  • General Science & Technology
  • Female
  • Emergency Service, Hospital
 

Citation

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Prattipati, S., Sakita, F. M., Kweka, G. L., Tarimo, T. G., Peterson, T., Mmbaga, B. T., … Hertz, J. T. (2021). Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study. PLoS One, 16(7), e0254609. https://doi.org/10.1371/journal.pone.0254609
Prattipati, Sainikitha, Francis M. Sakita, Godfrey L. Kweka, Tumsifu G. Tarimo, Timothy Peterson, Blandina T. Mmbaga, Nathan M. Thielman, Alexander T. Limkakeng, Gerald S. Bloomfield, and Julian T. Hertz. “Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study.PLoS One 16, no. 7 (2021): e0254609. https://doi.org/10.1371/journal.pone.0254609.
Prattipati S, Sakita FM, Kweka GL, Tarimo TG, Peterson T, Mmbaga BT, et al. Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study. PLoS One. 2021;16(7):e0254609.
Prattipati, Sainikitha, et al. “Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study.PLoS One, vol. 16, no. 7, 2021, p. e0254609. Pubmed, doi:10.1371/journal.pone.0254609.
Prattipati S, Sakita FM, Kweka GL, Tarimo TG, Peterson T, Mmbaga BT, Thielman NM, Limkakeng AT, Bloomfield GS, Hertz JT. Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study. PLoS One. 2021;16(7):e0254609.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2021

Volume

16

Issue

7

Start / End Page

e0254609

Location

United States

Related Subject Headings

  • Tanzania
  • Surveys and Questionnaires
  • Prospective Studies
  • Middle Aged
  • Logistic Models
  • Humans
  • Heart Failure
  • General Science & Technology
  • Female
  • Emergency Service, Hospital