A population-based incidence estimates of Sudden Cardiac Death (SCD) in sub-Saharan Africa (SSA) is unknown. We sought to determine the epidemiology of SCD in Douala, Cameroon.

During 12 months, 4 districts were randomly chosen to monitor all deaths. The COSA ("comité de santé") of each area registered every death, and a postgraduate fellow recorded detailed demographic and medical data for victims of natural death. A senior physician studied every case of suspected sudden death, either cardiac or extra-cardiac. For optimal exhaustiveness, surrounding hospital mortuaries were checked simultaneously to match identities of victims. Established SCD was defined as rapid witnessed collapses leading to death within 1h after the onset of symptoms, and probable SCD as unexpected death within 24h without obvious extra-cardiac cause. Our registry numbered 240 000 people and 2304 deaths. The overall mortality rate was 11.2/1000 inhabitants/year. Four (0.3%) were sudden extra-cardiac death, and 58 (2.5%) SCD of which 41.4% were established and 48.3% had <40 year-old. The incidence rate of SCD was 24.2/100 000 person-year. Coronary artery disease or dilated cardiomyopathy was able to be diagnosed in 13.8% cases. Out-of-hospital cardiac arrest (OHCA) occurred in 58.6% victims, of which 35.3% at home, and 58.8% in a cab, on the way towards hospital. Witness cardiac arrest was reported in 86.2% cases, but only 7.4% of victims experienced cardiopulmonary resuscitation attempts.

Although not negligible, the SCD incidence in this SSA population is lower than that reported in most of western countries. However, as the vast majority of cases are witnessed cardiac arrests, the absence of CPR attempts raises the question of educating populations in providing basic life support rescue to tackle this potential reversible fatal outcome.