Baseline Characteristics, Risk Factors and Etiology of Heart Failure Among Patients Hospitalized at a Teaching Hospital in Somalia: Cross-Sectional Study

Introduction: Heart failure (HF) is a heterogeneous syndrome and growing global epidemic estimated to affect over 26-million people worldwide. The aim of this study is to investigate baseline characteristics, risk factors, and etiology of HF among patients admitted to a tertiary hospital in Somalia. Methods: Between May and October 2021, data on epidemiological characteristics, risk factors, and etiology of HF among patients admitted to an emergency unit of a teaching hospital in Mogadishu, Somalia were retrospectively collected and analyzed. Results: A total of 155 patients were disgnosed with HF, their mean age was 65.9 ± 14 years, 46.5% (n = 72) were aged 65 years or older, and 58.7% (n=91) were female. The prevalence of HF was 3.4% (n = 155); 47.7% (n = 74) had HF with preserved ejection fraction (HFpEF), 34.9% HF with reduced ejection fraction (HFrEF), and 17.4% HF with mildly reduced ejection fraction (HFmrEF). More females than males had HFrEF and HFmrEF (77.8% vs 59.3%, p < 0.01). In contrast, HFpEF was more frequent in males (55.4% vs 44.6%, p < 0.01). Regarding cardiovascular disease risk factors, patients with HFpEF had advanced age (≥65), were male, and had co-morbid hypertensive heart disease (HHD) and thyroid disease. On the other hand, patients with HFrEF were more in older age (50–64 years), were women, and frequently had ischemic heart disease and diabetes mellitus compared to patients with HFpEF and HFmrEF. Among participants with HFpEF, HHD (58.1%) was the most common etiologies of HF, whereas in HFrEF, ischemic heart disease (38.9%) was prominent. Conclusion: HF in Somalia, different risk factors and etiologies were found in three groups of HF patients. Hypertension plays a predominant role both in its risk factors and the underlying cause of HF. We recommend implementation of specialized cardiac centers for the adult patients with cardiovascular diseases and promotion of the awareness of cardiovascular risk factors.