Clinical and socio demographic aspects of congestive heart failure patients at Kenyatta National Hospital, Nairobi

East Afr Med J. 1999 Jan;76(1):23-7.


Objective: To analyse the underlying aetiology, precipitating factors and certain socio-demographic determinants in patients admitted to Kenyatta National Hospital, Nairobi in congestive heart failure.

Design: Cross sectional descriptive study.

Subject: All patients aged thirteen years and above of either sex consecutively admitted with clinical diagnosis of congestive heart failure.

Setting: Kenyatta National Hospital (KNH), a national referral hospital. PATIENT EVALUATION: Detailed history including socio-demographic characteristics and physical examination was done. Patients underwent haematological and biochemistry tests followed by a chest x-ray, ECG and 2D Echo-doppler examination. Blood culture sensitivity was done when clinically indicated.

Results: Ninety one patients were studied, 44 males and 47 females. Almost 32% had rheumatic heart disease, 25.2% had cardiomyopathy, 17.6% hypertensive heart disease, 13.2% had pericardial disease while 2.2% had ischaemic heart disease. Three quarters of patients with hypertensive heart disease were above the age of 50 years, while 79% of patients with rheumatic heart disease were below the age of 30 years. Factors associated with patient deterioration leading to admission with congestive heart failure (CHF) included inadequate therapy (27.4%), arrhythmia (20.9%), respiratory infections (17.6%), anaemia (13.2%) and infective endocardiatis. Sixty two per cent of patients investigated were in New York Heart Association (NYHA) functional classification class IV, 31.9% in class III and 5.5% in class II.

Conclusion: Congestive heart failure constitutes 3.3% of all medical admissions at KNH. Rheumatic heart disease is the commonest cause of congestive heart failure in our set-up while inadequate therapy, arrhythmias and respiratory infections are the three major causes of decompensation in our patients with cardiac disease.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Female
  • Heart Failure / epidemiology
  • Heart Failure / etiology*
  • Humans
  • Kenya / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Statistics, Nonparametric