Noubiap JJ, Nkeck JR, Kwondom BS, et al. - Interventions aimed at decreasing the burden of infective endocarditis in Africa should be focused on rheumatic heart disease (the most prevalent risk factor in Africa). Outcomes of infective endocarditis in tertiary hospitals with good access to cardiac surgery appear to be relatively similar to those that have been observed in other parts of the world, especially in high-income countries.

• This systematic review and meta-analysis was focused on the incidence, risk factors, clinical pattern, microbiology, and outcomes of infective endocarditis in Africa.

• By exploring PubMed, Embase, African Index Medicus, and African Journals Online, a total of 42 studies documenting primary data for the epidemiology of infective endocarditis in populations within Africa were identified.

• The most common risk factor for infective endocarditis was rheumatic heart disease (52·0%) in adults and congenital heart disease (44·7%) in children.

• In 48·6% of patients with infective endocarditis, microbiological testing (mostly blood cultures) was positive; most commonly detected microorganisms were Staphylococcus species (41·3%) and Streptococcus species (34·0%).

• For infective endocarditis, pooled rate of surgical treatment was 49·1% and pooled in-hospital death rate was 22·6%.

• Heart failure (47·0%), acute kidney injury (22·8%), and embolic events (31·1%) comprised the other frequent complications.