article · Heart Rhythm O2
Rheumatic heart disease affects tens of millions of people globally, with the vast majority of cases occurring in developing nations. Patients living with the condition can experience neuropsychiatric complications, including cognitive impairment, which diminish their quality of life. A cross-sectional investigation of 216 patients aged 14 and older at a specialised cardiac institute in Tanzania evaluated the frequency of cognitive impairment using the General Practitioner Assessment of Cognition tool. Cognitive impairment was detected in 20.4 percent of the participants. Statistical analysis established that advancing age, positive HIV status, undernutrition, a history of atrial fibrillation, and a history of stroke were all independently linked to an increased likelihood of cognitive impairment. Consequently, screening for cognitive decline across all rheumatic heart disease patients is recommended, especially for individuals presenting with these identified clinical risk factors.
Rheumatic heart disease carries a substantial burden in low-income regions, yet its neurological and mental impacts are frequently overlooked. Documenting that one in five patients suffers from cognitive impairment highlights a critical care gap. Recognising risk factors like undernutrition, HIV, and atrial fibrillation enables clinicians to prioritise vulnerable individuals for cognitive screening, helping to safeguard patient quality of life.
The findings support the clinical adoption of standardised cognitive screening tools, such as the General Practitioner Assessment of Cognition, within routine cardiac care workflows. This informs healthcare providers and hospital administrators designing integrated chronic disease management protocols. Because the research represents an observational clinical study rather than product development, the abstract does not indicate a direct pathway to commercialisation.
AI-generated from the published abstract. Always read the original work before citing.
Background Globally, Rheumatic Heart Disease (RHD) affects 30 to 70 million people, with 90% in developing nations. In Tanzania, the RHD burden is 1-3%. Patients with RHD show neuropsychiatric manifestations like cognitive impairment (CI) with an effect on quality of life, but research in Tanzania is lacking. This study aimed to fill this gap. Objective This study aimed to determine the burden of CI and its associated factors among RHD patients at the Jakaya Kikwete Cardiac Institute (JKCI), Tanzania. Methodology We conducted a hospital-based cross-sectional study at JKCI from November, 2023 to February, 2024. A sample of 216 RHD patients aged ≥ 14 years provided informed consent or assent. Excluding those with pre-existing mental illness, recruitment used consecutive sampling. A questionnaire collected socio-demographic and clinical data. GPCOG tool assessed cognitive impairment. Data analysis employed STATA version 15.1. Ethical approval was obtained from MUHAS and JKCI Research and Ethics Committee. Results A total of 216 RHD-diagnosed patients were studied. The median age was 27 years with a female predominance (51.4%). More than half had attained a secondary level of education or higher (56.9%) and were insured (58.8%), while less than half were employed (40.7%). Regarding substance use, less than a quarter were cigarette smokers (5.6%) and over a quarter were alcohol drinkers (28.2%). The prevalence of cognitive impairment was 20.4%. Old age (aPR=1.04; 95% CI: 1.02-1.05, p<0.0001), positive HIV status (aPR=5.00; 95% CI: 1.85-13.53, p=0.02), undernutrition (aPR=2.44; 95% CI: 1.39-4.29, p<0.002), history of atrial fibrillation (aPR=3.16; 95% CI: 1.08-9.30, p=0.036), and history of stroke (aPR=2.58; 95% CI: 1.43-4.68, p=0.002) were independently associated with cognitive impairment. Conclusion and Recommendations Screening of all RHD patients for cognitive impairment, particularly those with atrial fibrillation, HIV, advanced age, undernutrition, and stroke history.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.1016/j.hroo.2025.08.032
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
