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. 2014 May 9;9(5):e96688.
doi: 10.1371/journal.pone.0096688. eCollection 2014.

Acute myocardial infarction in sub-Saharan Africa: the need for data

Julian T Hertz  1 , Joseph M Reardon  2 , Clarissa G Rodrigues  3 , Luciano de Andrade  4 , Alexander T Limkakeng  2 , Gerald S Bloomfield  5 , Catherine A Lynch  6
Affiliations

Acute myocardial infarction in sub-Saharan Africa: the need for data

Julian T Hertz et al. PLoS One. .

Abstract

Background: Trends in the prevalence of acute myocardial infarction in sub-Saharan Africa have not been well described, despite growing recognition of the increasing burden of cardiovascular disease in low- and middle-income countries. The aim of this systematic review was to describe the prevalence of acute myocardial infarction in sub-Saharan Africa.

Methods: We searched PubMed, EMBASE, Global Health Archive, CINAHL, and Web of Science, and conducted reference and citation analyses. Inclusion criteria were: observational studies, studies that reported incidence or prevalence of acute myocardial infarction, studies conducted in sub-Saharan Africa, and studies that defined acute myocardial infarction by EKG changes or elevation of cardiac biomarkers. Studies conducted prior to 1992 were excluded. Two independent reviewers analyzed titles and abstracts, full-texts, and references and citations. These reviewers also performed quality assessment and data extraction. Quality assessment was conducted with a validated scale for observational studies.

Findings: Of 2292 records retrieved, seven studies met all inclusion criteria. These studies included a total of 92,378 participants from highly heterogeneous study populations in five different countries. Methodological quality assessment demonstrated scores ranging from 3 to 7 points (on an 8-point scale). Prevalence of acute myocardial infarction ranged from 0.1 to 10.4% among the included studies.

Interpretation: There is insufficient population-based data describing the prevalence of acute myocardial infarction in sub-Saharan Africa. Well-designed registries and surveillance studies that capture the broad and diverse population with acute myocardial infarction in sub-Saharan Africa using common diagnostic criteria are critical in order to guide prevention and treatment strategies.

Registration: Registered in International Prospective Register of Systematic Reviews (PROSPERO) Database #CRD42012003161.

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Conflict of interest statement

Competing Interests: ATL has received research funding from Roche International and Abbott Laboratories, which manufacture troponin assays. The other authors have no relevant conflicts of interest. ATL's research grants listed in the Competing Interests section place no restrictions on the review article that we are submitting. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Methodological quality assessment of included studies.*Blue cells indicate a score of “1” (present) and white cells indicate a score of “0” (absent).
Figure 3
Figure 3
Locations of studies of AMI in Sub-Populations of Sub-Saharan Africa.
See this image and copyright information in PMC

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