10-Year Heart Failure Outcomes From Nurse-Driven Clinics in Rural Sub-Saharan Africa.
Sub-Saharan Africa
heart failure
integrated care delivery
outcomes
survival analysis
Journal
Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365
Informations de publication
Date de publication:
05 03 2019
05 03 2019
Historique:
received:
05
11
2018
revised:
11
12
2018
accepted:
11
12
2018
entrez:
2
3
2019
pubmed:
2
3
2019
medline:
24
1
2020
Statut:
ppublish
Résumé
Nurse-led delivery care models have the potential to address the significant burden of heart failure in sub-Saharan Africa. Starting in 2006, the Rwandan Ministry of Health, supported by Inshuti Mu Buzima (Partners In Health-Rwanda), decentralized heart failure diagnosis and care delivery in the context of advanced nurse-led integrated noncommunicable clinics at rural district hospitals. Here, the authors describe the first medium-term survival outcomes from the district level in rural sub-Saharan Africa based on their 10-year experience providing care in rural Rwanda. Kaplan-Meier methods were used to determine median time to event for: 1) composite event of known death from any cause, lost to follow-up, or transfer to estimate worst-case mortality; and 2) known death only. Five-year event-free rates were 41.7% for the composite outcome and 64.3% for known death. While death rates are encouraging, efforts to reduce loss to follow-up are needed.
Identifiants
pubmed: 30819366
pii: S0735-1097(19)30003-8
doi: 10.1016/j.jacc.2018.12.028
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
977-980Informations de copyright
Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.