Author + information
- Selma Carlsona,b,
- Herbie Dubera,b,
- Jane Achana,b,
- Gloria Ilikezia,b,
- Ali Mokdada,b,
- Andy Stergachisa,b,
- Alexandra Wolluma,b,
- Gene Bukhmana,b and
- Gregory Rotha,b
Background: Heart failure is a major cause of disease burden in Sub-Saharan Africa (SSA). There is an urgent need for better strategies for heart failure management in this region. However, there is little information on the capacity to diagnose and treat heart failure in SSA.
Objective: To provide a better understanding of the capacity to diagnose and treat heart failure in Kenya and Uganda, in order to inform policy planning and interventions.
Methods: We analyzed data from a nationally-representative survey of health facilities in Kenya and Uganda (197 health facilities in Uganda and 143 in Kenya). We report on the availability of cardiac diagnostic technologies and selected medications for heart failure. Based on available data in the ABCE survey we defined the heart failure medications package as including β blocker (propranolol or atenolol), angiotensin converting enzyme (ACE) inhibitor (captopril or lisinopril), and furosemide. Facility-level data was analyzed by country and platform type (hospital vs. ambulatory facilities).
Results: Functional and staffed radiography, ultrasound, and ECG were available in less than half of hospitals in Kenya and Uganda combined. Of the hospitals surveyed, 49% of Kenyan and 77% of Ugandan hospitals reported availability of the heart failure medication package. ACE inhibitors were only available in 51% of Kenyan and 79% of Ugandan hospitals. Almost one-third of the hospitals in each country had stock out of at least 1 of the medication classes in the prior quarter.
Conclusions: Our study showed that few facilities in Kenya and Uganda were prepared to perform necessary tests to diagnose and manage heart failure. A significant number of facilities in these countries did not have the essential medications needed to treat heart failure and drug shortages were common. Our findings call for increased investment in cardiac care to reduce the growing burden of heart failure.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Heart Failure: Evaluating Strategies to Prevent Readmissions
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1163-292
- 2017 American College of Cardiology Foundation