article · Communications Medicine
Cardiomyopathies, particularly dilated cardiomyopathy and hypertrophic cardiomyopathy, represent a growing public health challenge in low-resource settings across Africa, including Tanzania. This rising burden is driven by undiagnosed genetic factors, increasing rates of hypertension and infectious diseases, and poor access to specialist cardiac diagnostics and clinical care. While genetic testing supports early diagnosis, risk assessment, and personalised management in Europe and North America, its availability in Tanzania remains severely constrained. The existing epidemiology of these conditions in Tanzania is poorly defined, which hinders clinical outcomes. By evaluating local disease patterns, underlying genetics, and systemic health service barriers, actionable strategies are identified to introduce genetic testing and counselling. A context-specific approach grounded in real-world clinical and health system realities is critical for driving policy reform and establishing sustainable, equitable cardiogenetic services.
Cardiomyopathies often go undetected in low-resource environments until advanced stages, worsening patient outcomes. Exploring how to introduce genetic testing and counselling into health systems like Tanzania helps address critical diagnostic gaps. Tailoring solutions to local realities allows healthcare providers to identify high-risk individuals earlier, deliver more targeted interventions, and reduce the overall burden of cardiovascular disease.
The work focuses on early-stage health system strategy and policy pathways rather than a direct commercial product. It could eventually enable diagnostic laboratories and healthcare providers to implement clinical genetic testing and counselling services for cardiovascular disease in Tanzania. However, the work remains at an early conceptual and policy-proposal stage, with significant health system and infrastructural barriers still to be overcome before clinical services are established.
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Cardiomyopathies, particularly, dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) are significant and growing public health concerns in low resource settings, particularly Africa. This growing burden stems from undiagnosed genetic causes, rising hypertension and infectious diseases, and limited access to diagnostic and specialist cardiac care. However, the epidemiology of these conditions remains poorly defined. In Europe and North America, genetic testing has proven to be an important tool for early diagnosis for these conditions. Its use can be extended to risk assessment, personalized management, and increased understanding of disease mechanisms. However, the availability and implementation of genetic testing in Tanzania are limited, hindering its potential to improve patient outcomes. This Perspective evaluates the current epidemiology of cardiomyopathies in Tanzania, to provide a broader view on the underlying genetic factors, systemic barriers to implementing genetic testing and counseling, and proposes actionable solutions to overcome existing challenges. While similar needs have been recognized across Africa, this Perspective emphasizes how context-specific framing in Tanzania, grounded in real-world clinical and health system features, remains essential to catalyze local implementation and policy reform. Alimohamed et al. discuss the current status, challenges, and opportunities for implementing genetic counseling and testing for cardiomyopathies in Tanzania. It highlights critical system gaps and proposes practical strategies to build equitable, sustainable cardiogenetic services.
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DOI: 10.1038/s43856-025-01244-4
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