Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis

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dc.contributor.authorBigna, Jean Joël
dc.contributor.authorNoubiap, Jean Jacques
dc.contributor.authorNansseu, Jobert Richie
dc.contributor.authorAminde, Leopold Ndemnge
dc.date.accessioned2021-10-08T06:54:53Z
dc.date.available2021-10-08T06:54:53Z
dc.date.issued2017
dc.description.abstractBACKGROUND: Despite the recent increasing worldwide attention towards pulmonary hypertension (PH), its epidemiology remains poorly described in Africa. Accordingly, we performed a systematic review and meta-analysis of PH prevalence, incidence and etiologies in Africa. METHODS: We searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus. Published observational studies until September 20, 2017, including adult participants residing in Africa were considered. Two review authors independently selected studies, assessed included studies for methodological quality, and extracted data. A random-effects model was used for meta-analysis. Heterogeneity was evaluated by the χ 2 test on Cochrane's Q statistic which is quantified by I2 values. Using Newcastle-Ottawa Scale, we considered a score of 0-4, 5-7, and 8-10 as indicative of high, moderate, and low risk of bias in included studies, respectively. RESULTS: Of 1611 entries, 25 studies were retained. Twelve (48%), seven (28%), and six (24%) papers had respectively a low, moderate and high risk of bias. The prevalence of PH widely varied across different populations: 9.8% (95% confidence interval: 3.2-19.3; I2 = 99.4%; 6 studies) in 11,163 people presenting with cardiac complaints; 10.6% (4.3-19.1; I2 = 90.3%; 4 studies) in 937 HIV-infected people; 32.9% (17.6-50.4; I2 = 97.2%; 3 studies) in 2077 patients with heart failure; 23.2% (15.2-32.2; I2 = 59.4%; 3 studies) in 248 patients on hemodialysis; 12.9% (11.8-14.0; I2 = 79.7%; 2 studies) in 3750 patients with rheumatic heart disease; 36.9% (29.7-44.3; I2 = 79.7; 2 studies) in 79 patients with sickle cell disease; 62.7% (49.0-74.7; 1 study) in 51 patients with chronic obstructive pulmonary disease; 25.4% (16.3-37.3; 1 study) in 63 patients with systemic lupus erythematous; 68.7% (62.8-74.1; 1 study) in 259 patients with cardiac surgery; and 7.4% (4.6-11.9; 1 study) in 202 patients with systemic sclerosis. No study reported PH incidence. From one international study (n = 209), PH etiologies were: left heart disease (68.9%), pulmonary arterial hypertension (15.8%), lung disease and/or hypoxia (12.0%), chronic thromboembolic PH (1.9%) and unclear/multifactorial PH (15.8%). CONCLUSION: The prevalence of PH is relatively high in some populations in Africa, perhaps mainly driven by left heart diseases, highlighting the need for context-specific interventions.
dc.identifier.apacitationBigna, J. J., Noubiap, J. J., Nansseu, J. R., & Aminde, L. N. (2017). Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis. <i>BMC Pulmonary Medicine</i>, 17(1), 174 - 177. http://hdl.handle.net/11427/34366en_ZA
dc.identifier.chicagocitationBigna, Jean Joël, Jean Jacques Noubiap, Jobert Richie Nansseu, and Leopold Ndemnge Aminde "Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis." <i>BMC Pulmonary Medicine</i> 17, 1. (2017): 174 - 177. http://hdl.handle.net/11427/34366en_ZA
dc.identifier.citationBigna, J.J., Noubiap, J.J., Nansseu, J.R. & Aminde, L.N. 2017. Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis. <i>BMC Pulmonary Medicine.</i> 17(1):174 - 177. http://hdl.handle.net/11427/34366en_ZA
dc.identifier.issn1471-2466
dc.identifier.ris TY - Journal Article AU - Bigna, Jean Joël AU - Noubiap, Jean Jacques AU - Nansseu, Jobert Richie AU - Aminde, Leopold Ndemnge AB - BACKGROUND: Despite the recent increasing worldwide attention towards pulmonary hypertension (PH), its epidemiology remains poorly described in Africa. Accordingly, we performed a systematic review and meta-analysis of PH prevalence, incidence and etiologies in Africa. METHODS: We searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus. Published observational studies until September 20, 2017, including adult participants residing in Africa were considered. Two review authors independently selected studies, assessed included studies for methodological quality, and extracted data. A random-effects model was used for meta-analysis. Heterogeneity was evaluated by the χ 2 test on Cochrane's Q statistic which is quantified by I2 values. Using Newcastle-Ottawa Scale, we considered a score of 0-4, 5-7, and 8-10 as indicative of high, moderate, and low risk of bias in included studies, respectively. RESULTS: Of 1611 entries, 25 studies were retained. Twelve (48%), seven (28%), and six (24%) papers had respectively a low, moderate and high risk of bias. The prevalence of PH widely varied across different populations: 9.8% (95% confidence interval: 3.2-19.3; I2 = 99.4%; 6 studies) in 11,163 people presenting with cardiac complaints; 10.6% (4.3-19.1; I2 = 90.3%; 4 studies) in 937 HIV-infected people; 32.9% (17.6-50.4; I2 = 97.2%; 3 studies) in 2077 patients with heart failure; 23.2% (15.2-32.2; I2 = 59.4%; 3 studies) in 248 patients on hemodialysis; 12.9% (11.8-14.0; I2 = 79.7%; 2 studies) in 3750 patients with rheumatic heart disease; 36.9% (29.7-44.3; I2 = 79.7; 2 studies) in 79 patients with sickle cell disease; 62.7% (49.0-74.7; 1 study) in 51 patients with chronic obstructive pulmonary disease; 25.4% (16.3-37.3; 1 study) in 63 patients with systemic lupus erythematous; 68.7% (62.8-74.1; 1 study) in 259 patients with cardiac surgery; and 7.4% (4.6-11.9; 1 study) in 202 patients with systemic sclerosis. No study reported PH incidence. From one international study (n = 209), PH etiologies were: left heart disease (68.9%), pulmonary arterial hypertension (15.8%), lung disease and/or hypoxia (12.0%), chronic thromboembolic PH (1.9%) and unclear/multifactorial PH (15.8%). CONCLUSION: The prevalence of PH is relatively high in some populations in Africa, perhaps mainly driven by left heart diseases, highlighting the need for context-specific interventions. DA - 2017 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Pulmonary Medicine LK - https://open.uct.ac.za PY - 2017 SM - 1471-2466 T1 - Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis TI - Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis UR - http://hdl.handle.net/11427/34366 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34366
dc.identifier.vancouvercitationBigna JJ, Noubiap JJ, Nansseu JR, Aminde LN. Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis. BMC Pulmonary Medicine. 2017;17(1):174 - 177. http://hdl.handle.net/11427/34366.en_ZA
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBMC Pulmonary Medicine
dc.source.journalissue1
dc.source.journalvolume17
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12890-017-0549-5
dc.subject.otherAfrica
dc.subject.otherEpidemiology
dc.subject.otherMeta-analysis
dc.subject.otherPulmonary arterial hypertension
dc.subject.otherPulmonary hypertension
dc.subject.otherSystematic review
dc.titlePrevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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