title: Contemporary aetiology, clinical characteristics and prognosis of adults with heart failure observed in a tertiary hospital in Tanzania: the prospective Tanzania Heart Failure (TaHeF) study.
abstract: OBJECTIVE
  This study aimed to describe the contemporary aetiology, clinical characteristics and mortality and its predictors in heart failure (HF) in Tanzania.
  
  
  METHODS
  Design; Prospective observational study. Setting; Cardiovascular Center of the Muhimbili National Hospital in Dar es Salaam, Tanzania. Patients ≥18 years of age with HF defined by the Framingham criteria.
  
  
  METHODS
  All-cause mortality.
  
  
  RESULTS
  Among 427 included patients, 217 (51%) were females and the mean (SD) age was 55 (17) years. HF aetiologies included hypertension (45%), cardiomyopathy (28%), rheumatic heart disease (RHD) (12%) and ischaemic heart disease (9%). Concurrent atrial fibrillation (AF), clinically significant anaemia, diabetes, tuberculosis and HIV were found in 16%, 12%, 12%, 3% and 2%, respectively, while warfarin was used in 3% of the patients. The mortality rate, 22.4 per 100 person-years over a median follow-up of 7 months, was independently associated with AF, HR 3.4 (95% CI 1.6 to 7.0); in-patient 3.2 (1.5 to 6.8); anaemia 2.3 (1.2 to 4.5); pulmonary hypertension 2.1 (1.1 to 4.2) creatinine clearance 0.98 (0.97 to 1.00) and lack of education 2.3 (1.3 to 4.2).
  
  
  CONCLUSIONS
  In HF in Tanzania, patients are younger than in the developed world, but aetiologies are becoming more similar, with hypertension becoming more and RHD less important. Predictors of mortality possible to intervene against are anaemia, AF and lack of education.
authors.affiliation: Cardiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: Abel
authors.initials: A
authors.lastname: Makubi
authors.affiliation: Cardiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Camilla
authors.initials: C
authors.lastname: Hage
authors.affiliation: School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania Cardiovascular Center, Muhimbili National Hospital, Dar es Salaam, Tanzania.
authors.forename: Johnson
authors.initials: J
authors.lastname: Lwakatare
authors.affiliation: Cardiovascular Center, Muhimbili National Hospital, Dar es Salaam, Tanzania.
authors.forename: Peter
authors.initials: P
authors.lastname: Kisenge
authors.affiliation: School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
authors.forename: Julie
authors.initials: J
authors.lastname: Makani
authors.affiliation: Cardiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.affiliation: Cardiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Lars H
authors.initials: LH
authors.lastname: Lund
mesh_terms: D000740:Anemia / Q000453:epidemiology*; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011379:Prognosis; D011446:Prospective Studies; D013636:Tanzania / Q000453:epidemiology; D062606:Tertiary Care Centers; D014376:Tuberculosis / Q000453:epidemiology*; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D014859:Warfarin
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