Current Trends in the Prevalence and Aetiology of Childhood Congestive Cardiac Failure in Sagamu

Abstract

Congestive cardiac failure (CCF) is a common paediatric emergency with diverse aetiologies. The objective of this study is to define the current prevalence rate and common causes of CCF among children hospitalized in a Nigerian Tertiary Hospital. The study was prospectively done over a 1-year period in the Paediatric Wards of the hospital. Consecutive children aged 0-14 years, who fulfilled the standard diagnostic criteria for CCF were recruited. Data obtained from them included the age, sex, duration of illness and the socioeconomic status of the parents. Each subject was given a specific diagnosis based on the clinical, laboratory and radiological features. Out of a total of 1552 admissions, 109 had CCF giving the prevalence of 7.02%. The mean age of children with CCF was mean of 2 +/- 3.1 years (range: 1 day to 14 years). Ninety-five (91%) of them were concentrated in the lower socioeconomic classes III-V. The aetiologies of CCF identified in this study were as follows: severe anaemia occurring alone (48; 46%), lower respiratory tract infections (LRTI) (30; 29%), anaemia with LRTI (12; 11.5%), congenital heart diseases (CHD) (11; 10.5%), rheumatic heart disease (1; 1%), myocarditis (1; 1%) and chronic renal disease (1; 1%). Malaria was the commonest cause of anaemia while bronchopneumonia was the commonest form of LRTI in the subjects. Measles infection was associated with LRTI in 10 (23.8%) children. Three children had HIV-related anaemia. Infants formed the bulk of the subjects with CCF due to anaemia, LRTI and CHD. Ventricular septal defect was the commonest CHD identified. The prevalence obtained from this study was higher than rates obtained from some previous studies in the country. Severe anaemia is the commonest cause of CCF probably from the effects of severe malaria and increasing poverty. Stringent attention to poverty alleviation and malaria control may reduce the burden of CCF among Nigerian children.

Pattern of congestive heart failure in a Kenyan paediatric population : cardiovascular topics

“…This is, however, lower than the 28–46% reported from Nigeria 5,12. The contrast between European and African countries is concordant with the suggestion that causes of congestive heart failure in a Kenyan paediatric population depend on the stage of epidemiological transaction.…”

“…In the current study, it constituted 14.6% of heart failure. It was notably higher than the 1% reported in Nigeria 5,12. This implies that control of rheumatic heart disease, for example, by prudent treatment of throat infections would substantially reduce congestive heart failure in a Kenyan paediatric population due to acquired causes.…”

“…Its pattern varies between and within countries 3-5. In sub-Saharan Africa, studies mainly from Nigeria reveal that it accounts for 5.8–9.0% of emergency admissions to paediatric units 2,4,5.…”

“…Its pattern varies between and within countries 3-5. In sub-Saharan Africa, studies mainly from Nigeria reveal that it accounts for 5.8–9.0% of emergency admissions to paediatric units 2,4,5. These causes vary between developed and developing countries, age and geographical location 6,7.…”

Usefulness of amino terminal pro-B-type natriuretic peptide in evaluating children with cardiac failure

“…However, these studies (13,14) were mainly done in adults in whom cardiac failure is of a different etiopathogenesis, compared to cardiac failure in children. The few studies in children (11,12) have not included the etiologic factors of heart failure as seen in our locale such as bronchopneumonia, septicemia and severe anemia (4)(5)(6)15). Furthermore, the cut-off values that have been reported have varied widely depending on the study population and the outcome parameter being evaluated.…”