The Prevalence of Sexual Dysfunction and Associated Factors Among Ambulant Heart Failure Patients Attending Kenyatta National Hospital

Abstract

Background: Sexual activity is an important determinant of quality of life among chronic heart failure patients. Globally, Heart failure poses major public health burden with high morbidity and mortality. Despite numerous studies in other part of the world, sexual dysfunction is underrecognized and not sufficiently reported in Africa. This study has therefore clinical and epidemiological relevance Objective: To determine the prevalence of sexual dysfunction and related factors among ambulatory Heart failure patients attending the adult cardiology clinic at Kenyatta National Hospital. Method: A descriptive cross-sectional study design carried out at the KNH adult cardiology clinic. Ambulatory patients over the age of 18 years with a documented diagnosis of HF based on Framingham’s criteria on follow up at the KNH cardiology clinic for three months were randomly sampled. The presence of female sexual dysfunction and male erectile dysfunction were assessed using Female Sexual Function Index (FSFI-6) and male Erectile dysfunction International Index of Erectile Function (IIEF-5) version respectively. Analysis: Prevalence of erectile dysfunction or female sexual dysfunction among heart failure patients was determined as a proportion of men with ED or women with FSD and reported as a percentage. The association between sexual dysfunctions with some selected socio-demographic and clinical characteristics was analyzed using the Pearson chi-square for categorical data, and independent t-tests for continuous data. The odds ratio, as well as the 95% confidence interval, was calculated. The p-value was set at < 0.05 Results: A total of 306 heart failure patients were recruited for the study. 164 (53.6%) were male with mean age of 52.1 ± 17.2 years, and 142 (46.4%) were female with mean age of 53.1 ± 15.2years. The prevalence of ED in heart failure is 71.3%, with 45.7% of male patients experiencing mild, 12.2% moderate, and 13.4% severe erectile dysfunction. The prevalence of Female sexual dysfunction in Heart failure is 81.0% with 44.4%,12.0% and 24.6% reporting mild, moderate and severe FSD respectively. Increasing age, advanced NYHA class and presence of comorbities such as diabetes, hypertension as reported in our study was associated with increased erectile dysfunction. Conclusions: This study demonstrated that majority of heart failure patients have sexual dysfunction with majority of those having mild sexual dysfunction