Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis
Abstract 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 Pu...
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doaj-5fedfcff9b874a87a182c1a516dd88232020-11-24T21:54:40ZengBMCBMC Pulmonary Medicine1471-24662017-12-011711910.1186/s12890-017-0549-5Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysisJean Joel Bigna0Jean Jacques Noubiap1Jobert Richie Nansseu2Leopold Ndemnge Aminde3Department of Epidemiology and Public Health, Centre Pasteur of CameroonDepartment of Medicine, Groote Schuur Hospital and University of Cape TownDepartment of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1Clinical Research Education, Networking and Consultancy (CRENC)Abstract 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.http://link.springer.com/article/10.1186/s12890-017-0549-5Pulmonary hypertensionPulmonary arterial hypertensionAfricaSystematic reviewMeta-analysisEpidemiology |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jean Joel Bigna Jean Jacques Noubiap Jobert Richie Nansseu Leopold Ndemnge Aminde |
spellingShingle |
Jean Joel Bigna Jean Jacques Noubiap Jobert Richie Nansseu Leopold Ndemnge Aminde Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis BMC Pulmonary Medicine Pulmonary hypertension Pulmonary arterial hypertension Africa Systematic review Meta-analysis Epidemiology |
author_facet |
Jean Joel Bigna Jean Jacques Noubiap Jobert Richie Nansseu Leopold Ndemnge Aminde |
author_sort |
Jean Joel Bigna |
title |
Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis |
title_short |
Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis |
title_full |
Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis |
title_fullStr |
Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis |
title_full_unstemmed |
Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis |
title_sort |
prevalence and etiologies of pulmonary hypertension in africa: a systematic review and meta-analysis |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2017-12-01 |
description |
Abstract 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. |
topic |
Pulmonary hypertension Pulmonary arterial hypertension Africa Systematic review Meta-analysis Epidemiology |
url |
http://link.springer.com/article/10.1186/s12890-017-0549-5 |
work_keys_str_mv |
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