Prevalence, Etiology, and Fatality Rates of Childhood Heart Failure in Nigeria: A Systematic Review and Meta-analysis

Objectives: The objectives of the study were to describe the burden, etiology, and fatality rates of heart failure in Nigerian children. Methods: We searched PubMed database, Google scholar, TRIP database, EMBASE, African Index Medicus, and reference lists of selected articles for studies on burden, etiology, and fatality rates of heart failure in children in Nigeria published from 1977 to 2016. Two researchers reviewed the papers independently. Ten studies were selected that included 14,921 children and 1353 with heart failure. Results: The overall prevalence of heart failure using all the studies reviewed was 8.3% (95% CI: 4.9-12.6). The prevalence was 13.4% (95% CI: 10.9-16.3) in studies that excluded neonates and 4.5% (95% CI: 2.8-6.5) in studies that included neonates. The most common causes of heart failure were severe anemia (38.9%, 95% CI: 30.0-49.4), respiratory tract infections (32.4%, 95% CI: 25.5-39.7), congenital heart disease (8.4%, 95% CI: 6.8-10.2), and sepsis (7.6%, 95% CI: 3.0-14.0). The overall fatality rate was 16.0% (95% CI: 9.0 - 24.6) and was higher in studies that include neonates. Conclusion: Heart failure is common in children hospitalized in Nigeria. Its etiology is largely from non-cardiac conditions associated with severe hypoxia and mortality rates are high in children in Nigeria.