Heart failure in Somalia: a scoping review of the epidemiology, etiology, clinical characteristics, management, outcomes, and evidence gaps.

BACKGROUND

Heart 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.

METHODS

PubMed/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.

RESULTS

The 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.

CONCLUSIONS

The 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.