Supplementary file 1_Heart failure in Somalia: a scoping review of the epidemiology, etiology, clinical characteristics, management, outcomes, and evidence gaps.docx

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.</p>Results<p>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.</p>Conclusions<p>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.</p>