Prevalence of anemia in congestive heart failure patients at Muhimbili National Hospital Dar es Salaam - Tanzania

Abstract

Background: Anemia increases morbidity and mortality in patients with congestive Heart failure. Few studies have examined the prevalence of anemia and its impact among congestive heart failure patients in Africa. This study determined the prevalence of anemia in patients with congestive heart failure attending Muhimbili National Hospital, the national referral hospital in Dar es Salaam Tanzania.

Methods: This was a descriptive cross sectional study of patients admitted in medical wards and patients referred to medical out patient's clinics with a diagnosis of Congestive heart Failure at Muhimbili National Hospital. From October 2009 to January 2010 a total of 140 patients met the inclusion criteria and were recruited into the study. Anemia was defined as ... per WHO as hemoglobin level <13g/dl for men and <12g/dl for female. Patients were classified according to the NYHA.• All. patients had a full haemogram, serum Ferritin, biochemical profile, CXR, ECG and echocardiography.

Results: Anemia was found in 1081140 (77.1%) of patients. The mean age was 42±20. Males were older than females with median age of 47 (range 14-94) years as compared to median age of 35(range 10-85) years in females. The prevalence of anemia was significantly higher in males (84.9%) than in females (70.3%), p=0.0040.The risk of having anemia increased with severity of NYHA (p=0.0018). Most of the patients with anemia were found to be in NYHA functional class III and IV. Normocytic normochromic was the common type of anemia (78% of anemic patients), while microcytic hypochromic anemia was found in only 17% of the patients. Anemic patients were also found to have significantly low haematocrit (p=O.OOO 1) and higher creatinine level (p= 0.0076) .Renal function impairment as a eo-morbidity (estimated Glomerular filtration Rate <60mls/min) was found in 62% and was associated with the presence of anemia

VI Conclusion: The prevalence of anemia in patients with congestive heart failure attending Muhimbili national hospital was high (77%). The prevalence was higher in patients with NHY A class III and IV , and was significantly associated with low haematocrit level, increased serum creatinine level, impaired renal functions (estimated Glomerular filtration Rate <60mils/min) Recommendation: Improve awareness that anemia IS common In CHF and should be addressed as important eo morbidity.