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Epidemiology of pericardial diseases in Africa: a systematic scoping review
  1. Jean Jacques Noubiap1,
  2. Valirie Ndip Agbor2,3,
  3. Aude Laetitia Ndoadoumgue4,
  4. Jan René Nkeck5,
  5. Arnaud Kamguia5,
  6. Ulrich Flore Nyaga5,
  7. Mpiko Ntsekhe1,6
  1. 1Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
  2. 2Ibal Sub-divisional Hospital, Oku, Cameroon
  3. 3Department of Clinical Research, Health Education and Research Organization (HERO), Cameroon
  4. 4School of Health and Related Research, The University of Sheffield, Sheffield, UK
  5. 5Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
  6. 6Division of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
  1. Correspondence to Dr Jean Jacques Noubiap, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town 7925, South Africa; noubiapjj{at}


Objectives This scoping review sought to summarise available data on the prevalence, aetiology, diagnosis, treatment and outcome of pericardial disease in Africa.

Methods We searched PubMed, Scopus and African Journals Online from 1 January 1967 to 30 July 2017 to identify all studies published on the prevalence, aetiologies, diagnosis, treatment and outcomes of pericardial diseases in adults residing in Africa.

Results 36 studies were included. The prevalence of pericardial diseases varies widely according to the population of interest: about 1.1% among people with cardiac complaints, between 3.3% and 6.8% among two large cohorts of patients with heart failure and up to 46.5% in an HIV-infected population with cardiac symptoms. Tuberculosis is the most frequent cause of pericardial diseases in both HIV-uninfected and HIV-infected populations. Patients with tuberculous pericarditis present mostly with effusive pericarditis (79.5%), effusive constrictive pericarditis (15.1%) and myopericarditis (13%); a large proportion of them (up to 20%) present in cardiac tamponade. The aetiological diagnosis of pericardial diseases is challenging in African resource-limited settings, especially for tuberculous pericarditis for which the diagnosis is not definite in many cases. The outcome of these diseases remains poor, with mortality rates between 18% and 25% despite seemingly appropriate treatment approaches. Mortality is highest among patients with tuberculous pericarditis especially those coinfected with HIV.

Conclusion Pericardial diseases are a significant cause of morbidity and mortality in Africa, especially in HIV-infected individuals. Tuberculosis is the most frequent cause of pericardial diseases, and it is associated with poor outcomes.

  • pericardial disease
  • pericarditis
  • cardiac tamponade
  • prevalence
  • aetiologies
  • treatment
  • outcome
  • Africa

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  • ALN, JRN, AK and UFN contributed equally.

  • Contributors JJN conceived the study. JJN did the literature searched and selected studies with VNA. JJN, UFN, ALN, AK, JRN and VNA collected data. JJN summarised and interpreted the data. JJN, VNA and MN drafted the manuscript. All authors revised the manuscript for intellectual content. All authors approved the final version of the manuscript. JJN is the guarantor of the review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.