title: Heart failure in sub-Saharan Africa: review of the aetiology of heart failure and the role of point-of-care biomarker diagnostics.
abstract: Within Africa, the burden of heart failure is significant. This arises from the increase in cardiovascular disease and associated risk factors such as hypertension and diabetes, as well as causes of heart failure which are particular to sub-Saharan Africa, such as endomyocardial fibrosis. The lack of access to echocardiography and other imaging modalities, from a cost and technical perspective, combined with the predominantly rural nature of many countries with poor transport links, means that the vast majority of people never obtain an appropriate diagnosis. Similarly, research has been limited on the causes and treatment of heart failure in Africa and in particular endemic causes such as EMF and rheumatic heart disease. This review outlines the burden of heart failure in Africa and highlights the opportunity to expand diagnosis through the use of biomarkers, in particular natriuretic peptides. This builds on the success of point-of-care testing in human immunodeficiency virus and tuberculosis which have been extensively deployed in community settings in Africa.
authors.affiliation: gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.
authors.forename: Nadezhda
authors.initials: N
authors.lastname: Glezeva
authors.affiliation: gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.
authors.forename: Joe
authors.initials: J
authors.lastname: Gallagher
authors.affiliation: gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.
authors.forename: Mark
authors.initials: M
authors.lastname: Ledwidge
authors.affiliation: Global eHealth Unit, Imperial College London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: O'Donoghue
authors.affiliation: gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.
authors.forename: Kenneth
authors.initials: K
authors.lastname: McDonald
authors.affiliation: Mzuzu Central Hospital, Mzuzu, Malawi.
authors.forename: John
authors.initials: J
authors.lastname: Chipolombwe
authors.affiliation: gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.
authors.forename: Chris
authors.initials: C
authors.lastname: Watson
keywords: Manejo del fallo cardiaco en países con ingresos medios y bajos; cardiomiopatía; cardiomyopathie; cardiomyopathy; diagnostic de l'insuffisance cardiaque; diagnostics sur le lieu des soins en zone rurale en Afrique; diagnóstico del fallo cardiaco; fallo cardiaco global; global heart failure; heart failure diagnosis; heart failure management in low- and middle-income countries; insuffisance cardiaque globale; natriuretic peptide; peptide natriurétique; point-of-care diagnostics in rural Africa; prise en charge de l'insuffisance cardiaque dans les pays à revenus faibles et moyens; pruebas de diagnóstico inmediato en África rural; péptido natriurético