Infectious Endocarditis in Sub-Saharan Africa: Epidemic-Clinical Aspects, Evolutionary and Prognostic: Multicentre Study on 81 Cases Followed Over 1 Year in Lomé (Togo)

Abstract

Introduction: Infectious endocarditis remains a relatively common, serious pathology and suffering heavy mortality in sub-Saharan Africa. Purpose: The objective of this study was to describe the epidemic-clinical, evolutionary aspects patients hospitalized for infectious endocarditis and assess their prognosis. Methods: This is a prospective, 5-year, multicentre study of 81 hospitalized patients and treated for infectious endocarditis. These patients were followed for at least a year. Results: We observed that in our sub-Saharan context, patients who suffer from infectious endocarditis are often young, with an average age of 30 years. Rheumatic valve disease and congenital heart disease underlying the most frequent. Blood cultures are often negative, making it difficult the choice of appropriate antibiotic therapy. Surgical treatment (heart surgery) is difficult to access (2% in our study). As a result, the mortality is very high (63% at 1 year), with a survival rate of only 37% at 1 year. Conclusion: Our study shows that despite progress in diagnosis and therapeutic management, infectious endocarditis remains a pathology serious with heavy mortality in sub-Saharan Africa. It is important to highlight the importance of prevention, early diagnosis of infectious endocarditis, and especially the need for early medical-surgical management of these patients to improve their prognosis.