Rheumatic Heart Disease in Children: Epidemiological Aspects. Diagnostic and Evolutive at the Dakar Chu

Abstract

Rheumatic heart disease is the ultimate consequence of acute articular rheumatism. It remains a public health problem in developing countries. It is a pathology found in all countries of the world, with a clear predominance in developing countries. In Senegal, the hospital prevalence of rheumatic heart disease is 30.5%. Its seriousness lies in the risk of valvular sequel responsible for cardiac dysfunction that can lead to death. The objective of this study was to describe the epidemiological, diagnostic and evolutionary aspects of rheumatic heart disease at the Albert Royer National Hospital Center of child (CHNEAR). We had carried out a retrospective, descriptive and analytical study lasting 3 years from January 1, 2017 to December 31, 2019. All children aged 4 to 17 hospitalized at CHNEAR for rheumatic heart disease were included. The hospital prevalence was 0.8%. The average age was 10.9 years with a sex ratio of 0.875 in favor of girls. 85.47% of cases came from parents who had a low economic level of life. The history of repeated angina and acute articular rhumatism (AAR) was found respectively in 22.69 and 15.13% of cases. The clinical symptomatology was dominated by heart failure with 58.3% of cases, arthralgia in 7.5% of cases. The biological inflammatory syndrome was found in 86.1%. 73% of the patients had a positive antistreptolysin O antibody (ASLO). Cardiomegaly was found in 89.7%. Heart doppler ultrasound found polyvalvular involvement in more than half of the cases. Mitral insufficiency was the predominant valve disease in 98.20% of cases. The evolution was favorable in the majority of cases but 9.32% of deaths were observed.