Mortality following HF admission in Northwestern Tanzania remains high, and factors associated with post-hospital mortality may include poor linkage to post-discharge care and low sustained care engagement.
Mortality was very high both during the index HF hospitalization and after discharge among adults admitted to Bugando Medical Centre in 2023.
There were substantial gaps in the quality of inpatient and post-discharge HF care among patients discharged alive.
Attending the first post-discharge visit was independently associated with improved survival.
Remaining in care three months after discharge was independently associated with improved survival.
GDMT use was low across outpatient visits, with frequent medication changes and de-escalation over time.
The authors conclude that implementation research is needed to improve post-discharge HF outcomes in East Africa, focusing on pre-discharge GDMT optimization and early linkage to care.
This study looked at the records of 177 adults admitted with heart failure to a large referral hospital in Mwanza, Tanzania, in 2023, and followed them by chart review and phone calls until August 2025. Outcomes were poor: 13% died in the hospital, and of those who went home, about 41% died within six months and 56% within a year. Many patients did not receive recommended care after leaving the hospital. Only half were on the recommended heart failure medications at discharge, about two-thirds attended their first follow-up visit, just over half were still in care three months later, and fewer than 4 in 10 were on the recommended medications at that point. Patients who attended the first follow-up visit or who remained in care at three months had substantially lower risk of dying, even after accounting for other factors. This research suggests that getting patients onto appropriate medications before discharge and connecting them to follow-up care soon after may be important targets for improving survival. Because the study was a retrospective review at a single hospital, it shows associations rather than proving that follow-up care causes better survival. The authors call for further research on how to improve care engagement and medication use after heart failure hospitalization in East Africa.
Kalokola F, Wajanga B, Deodatus M, Mujuni E, Mayanja P, Majule D, et al.. (2026). Heart Failure Care and Post-Hospital Outcomes in Northwestern Tanzania.. Global heart. https://doi.org/10.5334/gh.1593