Observational studyGlobal heart2020
Patterns of Emergency Care for Possible Acute Coronary Syndrome Among Patients with Chest Pain or Shortness of Breath at a Tanzanian Referral Hospital.
Observational study in Global heart, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Acute Coronary Syndromes in Sub-Saharan Africa: A 10-Year Systematic Review.Journal of the American Heart Association · 2022Pooled it
- Trial
- Effect of an emergency department-based educational intervention on medication adherence and disease understanding after acute myocardial infarction in Tanzania.Frontiers in public health · 2026Article
- Long-Term Implementation and Effectiveness of a Quality Improvement Intervention for Myocardial Infarction in Tanzania.Annals of global health · 2026Article
- Acute coronary syndrome prevalence and outcomes in a Tanzanian emergency department: Results from a prospective surveillance study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- Article
- Implementation Outcomes of an Intervention to Improve Myocardial Infarction Care in Tanzania.Annals of global health · 2025Article
- Multicomponent Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Protocol for a Pilot Implementation Trial.JMIR research protocols · 2024Article
- Evaluating the performance of the HEART score in a Tanzanian emergency department.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Observational
- Improving acute myocardial infarction care in northern Tanzania: barrier identification and implementation strategy mapping.BMC health services research · 2024Article
- Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention.Annals of global health · 2024Article
- Provider attitudes towards quality improvement for myocardial infarction care in northern Tanzania.PLOS global public health · 2024Article
- Early Prediction in Classification of Cardiovascular Diseases with Machine Learning, Neuro-Fuzzy and Statistical Methods.Biology · 2023Article
- Treatment Seeking Behaviors and Associated Factors among Patients Experiencing Acute Coronary Syndrome Using Health Belief Model in Addis Ababa, Ethiopia.Ethiopian journal of health sciences · 2022Article
- Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward.Frontiers in cardiovascular medicine · 2022Review
- Prevalence and Correlates of Ischemic ECG Findings among Adults With and Without HIV in Tanzania.Global heart · 2022Article
- Incidence of Acute Myocardial Infarction in Northern Tanzania: A Modeling Approach Within a Prospective Observational Study.Journal of the American Heart Association · 2021Observational
- Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study.PloS one · 2021Observational
- Effect of a Triage-Based Screening Protocol on Diagnosis and Treatment of Acute Coronary Syndrome in a Tanzanian Emergency Department: A Prospective Pre-Post Study.Journal of the American Heart Association · 2020Article
- Acute myocardial infarction under-diagnosis and mortality in a Tanzanian emergency department: A prospective observational study.American heart journal · 2020Observational
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
Background: Acute coronary syndrome (ACS) is thought to be a rare diagnosis in sub-Saharan Africa, but little is known about diagnostic practices for patients with possible ACS symptoms in the region. Objective: To describe current care practices for patients with ACS symptoms in Tanzania to identify factors that may contribute to ACS under-detection. Methods: Emergency department patients with chest pain or shortness of breath at a Tanzanian referral hospital were prospectively observed. Medical histories were obtained, and diagnostic workups, treatments, and diagnoses were recorded. Five-year risk of cardiovascular events was calculated via the Harvard National Health and Nutrition Examination Survey risk score. Telephone follow-ups were conducted 30 days after enrollment. Results: Of 339 enrolled patients, the median (IQR) age was 60 (46, 72) years, 252 (74.3%) had hypertension, and 222 (65.5%) had >10% five-year risk of cardiovascular event. The median duration of symptoms prior to presentation was 7 days, and 314 (92.6%) reported symptoms worsened by exertion. Of participants, 170 (50.1%) received an electrocardiogram, and 9 (2.7%) underwent cardiac biomarker testing. There was no univariate association between five-year cardiovascular risk and decision to obtain an electrocardiogram ( Conclusions: Many patients with ACS risk factors present to the emergency department of a Tanzanian referral hospital with possible ACS symptoms, but marked delays in care-seeking are common. Complete diagnostic workups for ACS are uncommon, ACS is rarely diagnosed or treated with evidence-based therapies, and mortality in patients with these symptoms is high. Physician practices may be contributing to ACS under-detection in Tanzania, and interventions are needed to improve ACS care.
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