Abstract / Summary
Abstract Background Sudden cardiac death (SCD) is an important cause of premature mortality among young adults worldwide. Despite a substantial prevalence of SCD in young adults in Africa, its epidemiology is still poorly characterised. This systematic review aims to synthesise available African evidence on the burden, etiologies, and prevention strategies of SCD. Methods We searched PubMed, Embase, Scopus, Web of Science, the Cochrane Library, African Journals Online (AJOL), and Google Scholar from January 2000 to July 2026 for original studies on SCD in Africa. Studies that were eligible examined individuals aged 15–39 years across African populations and were published in English. Findings were synthesised thematically and presented narratively. Results Ten studies from Algeria (n = 2), Tunisia (n = 2), South Africa (n = 2), Cameroon (n = 1), Gabon (n = 1), Egypt (n = 1), and Nigeria (n = 1) were included in this review. Included study designs were retrospective autopsy-based studies, cohort studies, observational cross-sectional studies, and a prospective case-control study, conducted across hospital, community, and pre-competition sports screening settings. Reported age across cohorts ranged from 18 to 39 years, and males predominated. No studies reported prevalence figures; incidence ranged from 3 to 33.6 per 100,000 person-years. Cardiovascular disease was the leading identified cause across all settings, with hypertrophic cardiomyopathy accounting for 39.1% in one cohort. Hypertensive heart disease predominated in sub-Saharan Africa, while ischemic causes and cardiomyopathies were more prominent in North Africa. Other contributors identified included enteroviral myocarditis, HIV-associated disease, family history, and obesity. Inherited cardiovascular pathologies accounted for up to 90% of cases in individuals aged 45 years and under in one cohort. Gaps that were reported included limited autopsy utilisation, absent genetic testing infrastructure, and cultural barriers to post-mortem consent. Conclusion SCD in young African adults is shaped by a heterogeneous mix of acquired cardiovascular, infectious, and inherited disorders. Future priorities should include strengthening surveillance, expanding post-mortem investigation, integrating cardiovascular risk screening into primary care, and improving emergency response capacity.