The intersection of infectious diseases and cardiovascular disease in Africa: A narrative review.

In sub-Saharan Africa (SSA), the cardiovascular system can be significantly impacted by infections and infestations with the heart being a target of several neglected tropical diseases as well as some latent parasitic infections which may become reactivated in cases of immunosuppression, such as in individuals with HIV/AIDS. The African environment may provide a milieu for the existence and propagation of some of these infections with poor environmental hygiene, inadequate sanitation, substandard housing, and overcrowding contributing to the development and spread of infections, further exacerbating cardiovascular complications. The etiopathogenesis and clinical presentations of these infections are generally due to either direct cardiac involvement or a broader systemic illness with sequelae that can affect the pericardium, myocardium, and endocardium, as well as the blood vessels supplying the heart. Some parasitic infections, such as schistosomiasis, can cause pulmonary hypertension. While these infections are prevalent in many African countries, it is difficult to provide an exact estimate of cardiovascular involvement as there is a lack of extensive research specifically focused on the cardiac complications in the continent. Prompt detection of cardiac involvement is crucial to improve prognosis thus, future directions on the use of more sophisticated imaging (i.e., cardiac magnetic resonance imaging) may help in the early diagnosis of cardiovascular involvement. This paper therefore, offers a comprehensive review of the interplay between infectious diseases, infestations, neglected tropical diseases, and cardiovascular diseases in SSA. It emphasizes the complex interplay between these factors and the implications for public health and medical management in the region, which are compounded by limited healthcare resources and the high prevalence of co-infections.