Prevalence and Risk Factors of Readmission Among Patients with Cardiovascular Diseases in Africa: A Systematic Review

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality globally, with a disproportionately high burden in Africa. Readmissions among patients present an additional challenge. This systematic review aimed to map evidence on the prevalence and risk factors of readmissions among patients with CVDs in Africa. A systematic review was conducted following the PRISMA guidelines. Comprehensive searches were carried out in PubMed Central, Scopus, JSTOR, CINAHL and other databases. Studies published in English from January 2000 that reported on the prevalence and risk factors of readmission among CVD patients in Africa were included. The Joanna Briggs Institute critical appraisal tools were used to assess the quality of included studies. Descriptive and thematic analysis were used to synthesise the findings. A total of 37 records were included in the final synthesis. Heart failure was the most extensively studied CVD. The prevalence of readmission among patients with CVDs ranged from 1.53% to 67.7%. Older age (> 65 years) was a key predictor. Clinical factors included hypertension, arrhythmias, advanced disease stages including LVEF < 40%, NYHA Class II-IV, NHISS > 7, anemia, infections and chronic comorbidities. Facility-related factors comprised prolonged hospitalisation and discharge without essential medications (beta-blockers for heart failure, and aspirin, clopidogrel, statins for myocardial infarction). Poor adherence to treatment regimen emerged as self-management determinant. The findings suggest that readmissions among patients with CVDs in Africa remain a substantial burden. The review highlights the need for evidence-based interventions focusing on standardised discharge protocols, enhanced patient education, better screening of patients and management of comorbidities. Future research should address geographical gaps and focus on a wider range of CVDs to provide a more comprehensive overview.