Observational studyAmerican heart journal2020
Acute myocardial infarction under-diagnosis and mortality in a Tanzanian emergency department: A prospective observational study.
Observational study in American heart journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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The trial behind it
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
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Use of hospital services by patients with chronic conditions in sub-Saharan Africa: a systematic review and meta-analysis.Bulletin of the World Health Organization · 2023Pooled it
- Acute Coronary Syndromes in Sub-Saharan Africa: A 10-Year Systematic Review.Journal of the American Heart Association · 2022Pooled it
- Trial
- Observational
- Sustainability and normalization of an intervention to improve evidence-based myocardial infarction care in Tanzania.Implementation science communications · 2026Article
- Long-Term Implementation and Effectiveness of a Quality Improvement Intervention for Myocardial Infarction in Tanzania.Annals of global health · 2026Article
- Article
- 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
- Sustainability and normalization of an intervention to improve evidence-based myocardial infarction care in Tanzania.Research square · 2025Article
- Thirty-Day and One-Year All-Cause Mortality of ST-Segment Elevation Myocardial Infarction in Johannesburg, South Africa: Insights from the STEMI HOC-1 Prospective Study.Journal of cardiovascular development and disease · 2025Article
- Percutaneous coronary interventions in Sudan: insights from severely influenced conflict zone.Cardiovascular endocrinology & metabolism · 2025Article
- 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
- Transformation of Cardiology and Cardiothoracic Services at Benjamin Mkapa Hospital, Tanzania: Findings and Experiences from 1,313 Cardiovascular Procedures in Five Years.Global heart · 2025Article
- Implementation Outcomes of an Intervention to Improve Myocardial Infarction Care in Tanzania.Annals of global health · 2025Article
- Satisfaction of Nursing Care and Its Associated Factors Among Patients With Coronary Artery Disease at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania: A Cross-Sectional Study.Nursing research and practice · 2025Article
- Article
- Multicomponent Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Protocol for a Pilot Implementation Trial.JMIR research protocols · 2024Article
- Article
- 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
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundGrowing evidence suggests that under-diagnosis of acute myocardial infarction (AMI) may be common in sub-Saharan Africa. Prospective studies of routine AMI screening among patients presenting to emergency departments in sub-Saharan Africa are lacking. Our objective was to determine the prevalence of AMI among patients in a Tanzanian emergency department.
methodsIn a prospective observational study, consecutive adult patients presenting with chest pain or shortness of breath to a referral hospital emergency department in northern Tanzania were enrolled. Electrocardiogram (ECG) and troponin testing were performed for all participants to diagnose AMI types according to the Fourth Universal Definition. All ECGs were interpreted by two independent physician judges. ECGs suggesting ST-elevation myocardial infarction (STEMI) were further reviewed by additional judges. Mortality was assessed 30 days following enrollment.
resultsOf 681 enrolled participants, 152 (22.3%) had AMI, including 61 STEMIs and 91 non-STEMIS (NSTEMIs). Of AMI patients, 91 (59.9%) were male, mean (SD) age was 61.2 (18.5) years, and mean (SD) duration of symptoms prior to presentation was 6.6 (12.2) days. In the emergency department, 35 (23.0%) AMI patients received aspirin and none received thrombolytics. Of 150 (98.7%) AMI patients completing 30-day follow-up, 65 (43.3%) had died.
conclusionsIn a northern Tanzanian emergency department, AMI is common, rarely treated with evidence-based therapies, and associated with high mortality. Interventions are needed to improve AMI diagnosis, care, and outcomes.
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