Occurrence and pattern of congenital heart diseases in a rural area of sub-Saharan Africa

Tchoumi, Jacques Cabral Tantchou; Butera, Gianfranco; Giamberti, Alessandro; Ambassa, Jean Claude; Sadeu, Jean Clair

doi:10.5830/cvja-2010-046

Cited by 21 publications

(15 citation statements)

References 7 publications

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“…Many CHD cases in SSA are diagnosed at an advanced stage of their natural history when complications and contra-indications for corrective surgical interventions have already ensued [14,85]. A few hospitalbased studies with imaging capabilities have been conducted in SSA [9,14,[85][86][87]. A major study of 534 CHD patients at a cardiovascular referral center in Mozambique showed that complications were already present in 29% of cases at time of diagnosis.…”

Section: Congenital Heart Diseasementioning

confidence: 99%

“…Among patients with an abnormality that needed surgical correction or palliation, only 41% of those could be operated with surgery contraindicated because of severe pulmonary hypertension, severe malnutrition, cardiomyopathy, neurological deficit, and HIV infection [14]. In the Cameroonian study, CHD patients requiring surgery were on the waiting list for more than three months before operation, and around 10% of patients died before their scheduled surgery, with surgical procedures completely paid for by not-for-profit organizations [85].…”

Section: Congenital Heart Diseasementioning

confidence: 99%

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Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

et al. 2020

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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests that SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations. Highlights:-The burden of non-communicable diseases including cardiovascular diseases is rising in SSA.-Levels of hypertension diagnosis, treatment, and control are low at <40%, <35%, and 10-20%, respectively, and more than 40% of patients with diabetes are not aware of their diagnosis in SSA. -SSA has 23% of the world's prevalent rheumatic heart disease cases.-The leading causes of heart failure in SSA are hypertensive heart disease, cardiomyopathy, and rheumatic heart disease, with ischemic heart disease accounting for <10% of cases compared to >50% in high-income countries.

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Section: Congenital Heart Diseasementioning

confidence: 99%

Section: Congenital Heart Diseasementioning

confidence: 99%

Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

et al. 2020

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“…In patients with peripartum cardiomyopathy, prolonged corrected non-congenital QT interval and sinus tachycardia on baseline ECG were independent predictors of poor composite outcome which included death during follow-up [90]. Cardiomyopathies [58,61] Hypertensive heart disease [58,62,67] Coronary artery disease [58,59,61,64,69] Rheumatic heart disease [61,69] Congenital heart disease [96] Arrhythmogenic right ventricular cardiomyopathy [76,77] Hypertrophic cardiomyopathy [74,75] Brugada syndrome [78,79] Congenital Long QT syndrome (seen only in non-Black populations) [74,88,101] Ventricular non-compaction [84] Pulmonary embolism [62,91] Endomyocardial fibrosis [95] Pulmonary hypertension [61] Pericarditis (mainly tuberculous) [92] Aortic dissection/rupture [64] Endemic parasitic infections like trypanosomiasis & schistosomiasis [9,59,93] Sarcoidosis [102][103][104] Respiratory disease [58,62,64] Septicemia [58,66] HIV/AIDS [58,…”

Section: Reported Underlying Etiologies Of Sca/scd and Ventricular Armentioning

confidence: 99%

“…Endomyocardial fibrosis which is endemic in SSA has very poor prognosis with survival after diagnosis reported to be two years due to malignant arrhythmias, heart failure, and thromboembolism [95]. SCA/SCD due to congenital heart disease has been reported in SSA [96]. Short QT syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT), and other VTs forms have not been observed in the SSA literature.…”

Section: Reported Underlying Etiologies Of Sca/scd and Ventricular Armentioning

confidence: 99%

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Yuyun

Bonny

et al. 2020

Global Heart

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Major structural cardiovascular diseases are associated with cardiac arrhythmias, but their full spectrum remains unknown in sub-Saharan Africa (SSA), which we addressed in this systematic review. Atrial fibrillation/atrial flutter (AF/AFL) prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, but <1% in the general population. Use of oral anticoagulation is heterogenous (9-79%) across SSA. The epidemiology of sudden cardiac arrest/death is less characterized in SSA. Cardiopulmonary resuscitation is challenging, owing to low awareness and lack of equipment for life-support. About 18% of SSA countries have no cardiac implantable electronic devices services, leaving hundreds of millions of people without any access to treatment for advanced bradyarrhythmias, and implant rates are more than 200-fold lower than in the western world. Management of tachyarrhythmias is largely noninvasive (about 80% AF/AFL via rate-controlled strategy only), as electrophysiological study and catheter ablation centers are almost non-existent in most countries. Highlights:-Atrial fibrillation/flutter prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, and <1% in the general population in sub-Saharan Africa (SSA).-Rates of oral anticoagulation use for CHA2DS2VASC score ≥2 are very diverse (9-79%) across SSA countries.-Data on sudden cardiac arrest are scant in SSA with low cardiopulmonary resuscitation awareness.-Low rates of cardiac implantable electronic devices insertions and rarity of invasive arrhythmia treatment centers are seen in SSA, relative to the high-income countries.

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“…Congenital heart diseases (CHD) are of public health concern worldwide as they contribute signi icantly to childhood morbidity and mortality [1,2]. This is particularly so in developing countries, especially in sub-Saharan Africa, where non-communicable diseases in the paediatric age group are emerging major health and socioeconomic issues but facilities for early diagnosis and management are often lacking [2][3][4][5][6]. Congenital heart diseases (CHD) account for 8-12 / 1000 live births and approximately 30% to 40% of all individuals and also constitute appreciable inancial burden on the family and community [2,10].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of congenital heart diseases among primary school children in the Niger Delta Region of Nigeria, West Africa

Susan¹,

Nnena²,

Edewele³

2019

J Cardiol Cardiovasc Med

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congenital defects worldwide, occurring either in isolation or as part of other syndromic anomalies [7-9]. Children with CHD, especially those with critical lesions, usually present early in neonatal period, infancy and early childhood with increasing severity of their morbid state that often result in early mortality without intervention [2]. Some children with less severe lesions may survive beyond early childhood into adolescence and even adulthood, albeit with increasing morbidity and functional incapacity that result in poor quality of life and psychosocial drain for the affected

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Occurrence and pattern of congenital heart diseases in a rural area of sub-Saharan Africa

Cited by 21 publications

References 7 publications

Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Prevalence of congenital heart diseases among primary school children in the Niger Delta Region of Nigeria, West Africa

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