Home›Cardiology› Heart Failure Evidence in Somalia Is Fragmented and Insufficient to Estimate National Burden
Heart Failure Evidence in Somalia Is Fragmented and Insufficient to Estimate National BurdenReview Identifies Common Causes of Heart Failure in Somalia
Frontiers in MedicinePublished September 29, 2026DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Recognize that heart failure evidence in Somalia is fragmented and insufficient for national burden estimates.
This scoping review examined the available evidence on heart failure in Somalia, including Somaliland and Puntland, synthesizing 12 studies. The authors report that evidence is geographically concentrated, primarily from a single tertiary hospital in Mogadishu, and methodologically heterogeneous. No study provided nationally representative or multicentre evidence.
The review identified reported aetiologies and associated conditions including hypertension, ischaemic heart disease, valvular disease, cardiomyopathy, anaemia, thyroid dysfunction, renal disease, and thiamine-deficiency wet beriberi. Echocardiography was the principal diagnostic method. Secondary outcomes reported across studies included in-hospital mortality, first-year outcomes in a thrombus cohort, length of stay, stroke, thrombus resolution, and exploratory prognostic indices.
Key limitations noted by the authors include substantial variation in heart-failure definitions and ejection-fraction thresholds, and management data limited mainly to selected populations. The review states that evidence is fragmented and insufficient to estimate national burden, treatment coverage, or long-term outcomes.
Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. Funding or conflicts of interest were also not reported. The authors conclude that current evidence cannot support national burden estimates or treatment coverage assessments, and practice relevance remains uncertain.
How this fits prior evidence
This scoping review addresses a gap in heart failure evidence for Somalia, contrasting with prior coverage of mechanical circulatory support devices in selected heart failure and cardiogenic shock populations, and targeted left ventricular lead placement, which did not improve primary outcomes. Unlike those interventional findings, this review is descriptive and cannot estimate national burden or treatment coverage. It also parallels prior coverage of weight management programs lacking cultural adaptation and ethnicity-stratified reporting, and TCM-WM risk models limited by heterogeneity and risk of bias, reinforcing that evidence fragmentation and methodological limitations are recurring themes across cardiovascular topics.
A scoping review looked at 12 different studies to understand heart failure in Somalia, specifically in the Somaliland and Puntland regions. The research focused on patients treated at a major hospital in Mogadishu. The review identified several common underlying conditions that lead to heart failure, including high blood pressure, heart muscle disease, and valve problems.
Other factors linked to heart failure in this area included anemia, thyroid issues, kidney disease, and a specific vitamin deficiency called wet beriberi. Doctors primarily used echocardiography as the main tool to diagnose these heart conditions in the patients studied.
Because the data comes from a single hospital and a small number of studies, the findings are not representative of the entire country. The evidence is currently too limited to determine the total number of people affected or the success of long-term treatments. These results are helpful for identifying local health trends but cannot be used to determine specific treatment plans.
What this means for you:
Research identifies common causes of heart failure in Somalia, but more data is needed to understand national trends.
Common questions
What are the main causes of heart failure in this region?
The review identified several conditions linked to heart failure, including hypertension, ischaemic heart disease, valvular disease, and cardiomyopathy. Other contributing factors found in the studies included anaemia, thyroid dysfunction, renal disease, and thiamine-deficiency wet beriberi.
How is heart failure diagnosed in these cases?
Echocardiography was the principal diagnostic method used in the studies reviewed. This imaging test helps doctors see how well the heart is pumping and identify structural issues like valvular disease or heart muscle problems.
Can these results be applied to all patients in Somalia?
The evidence is currently limited because the data comes from a single hospital and is geographically concentrated. Because the studies were not nationally representative, the results cannot yet be used to estimate the total national burden or treatment coverage.
BackgroundHeart failure is an important cause of morbidity, hospitalisation, disability, and mortality, but evidence from Somalia remains fragmented and largely confined to individual hospital-based studies. This scoping review mapped the available evidence on the epidemiology, aetiologies, clinical and diagnostic characteristics, management, outcomes, and research gaps relating to heart failure in Somalia.MethodsPubMed/MEDLINE, Scopus, and Embase were searched from inception to 27 July 2026. Backward citation searching was conducted on 3 August 2026. Original studies reporting heart-failure-specific findings from Somalia, including Somaliland and Puntland, were eligible. Screening was conducted independently by two reviewers. Data were charted using a structured form and verified by a second reviewer. Findings were synthesised descriptively without meta-analysis because of substantial heterogeneity and possible participant overlap.ResultsThe searches identified 111 records, of which 56 were duplicates. Fifty-five records underwent title and abstract screening, 13 reports were assessed in full text, and 12 studies published between 2011 and 2025 were included. Eleven studies were associated with a single tertiary hospital in Mogadishu, and no study provided nationally representative or multicentre evidence. Reported aetiologies and associated conditions included hypertension, ischaemic heart disease, valvular disease, cardiomyopathy, anaemia, thyroid dysfunction, renal disease, and thiamine-deficiency wet beriberi. Echocardiography was the principal diagnostic method, but heart-failure definitions and ejection-fraction thresholds varied substantially. Management data were limited mainly to selected populations with thyroid dysfunction, left ventricular thrombus, or wet beriberi. Outcome reporting was sparse and included in-hospital mortality, first-year outcomes in a thrombus cohort, length of stay, stroke, thrombus resolution, and exploratory prognostic indices.ConclusionsThe evidence on heart failure in Somalia is emerging but remains geographically concentrated, methodologically heterogeneous, and insufficient to estimate national burden, treatment coverage, or long-term outcomes. Prospective multicentre studies and a staged heart-failure registry using standardised diagnostic definitions, clear denominators, treatment indicators, and longitudinal follow-up are needed.
