Prevalence and determinants of heart disease in Somaliland: An analysis of the 2020 Somaliland demographic and health survey (SLDHS)

Background: Cardiovascular diseases (CVDs) are a leading cause of death globally, particularly in low- and middle-income countries. While data on heart disease prevalence in Somaliland is limited, the 2020 Somaliland Demographic and Health Survey (SLDHS) provides a valuable opportunity to assess this critical public health issue. Methods: This study analyzed data from the 2020 SLDHS, a nationally representative crosssectional survey. We included 18,930 individuals after data cleaning and variable selection. Heart disease was the outcome variable, while demographic and socioeconomic factors, including age, sex, region, residence, wealth, tobacco use, diabetes, and hypertension, were analyzed as predictors using STATA version 17. Results: The prevalence of heart disease in Somaliland was 0.7 % (95 % CI [0.6 %, 0.9 %]). Significant associations were observed with: Sool region (AOR 1.86-6.821, p = 0.000), female sex (AOR 1.086-2.508, p = 0.019), older age groups (AOR 1.182-9.621, 1.073-11.247, 1.899-19.504 and 4.126-38.282, p = 0.023, 0.038, 0.002, 0.000 respectively), rural residence (AOR 1.025-2.198, p = 0.037), tobacco use, diabetes, and hypertension. Conclusion: This study highlights the importance of regional disparities, gender differences, and the impact of modifiable risk factors like tobacco use, diabetes, and hypertension in influencing heart disease prevalence in Somaliland. These findings emphasize the need for targeted interventions and public health strategies to address these factors and improve cardiovascular health outcomes in the region.