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Published on: February 14, 2019
Cardiovascular disease in children in Djibouti: a single-centre study
Pierre-Laurent Massoure1, Nicolas-Charles Roche, Gatien Lamblin
1Hôpital Laveran, 13 384 Marseille cedex 13, France.
Insights
Pediatric cardiovascular disease (CVD) is common in Djibouti, with congenital heart disease being most frequent. Lack of surgical intervention significantly increased mortality risk in children with heart conditions.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Epidemiology
- Global Health
Background:
- Limited data exists on pediatric cardiovascular disease (CVD) in the Horn of Africa.
- Djibouti represents a key region for understanding CVD prevalence in East Africa.
Purpose of the Study:
- To delineate the spectrum of cardiovascular disease (CVD) in children residing in Djibouti.
- To identify common CVD types and associated risk factors in a pediatric population.
Main Methods:
- Prospective study conducted over two years (2009-2010) at Bouffard Military Hospital, Djibouti.
- Inclusion of Djiboutian children aged 1 month to 15 years diagnosed with CVD.
- Data collection included clinical examination, echocardiography, and follow-up assessments.
Main Results:
- 32% of 156 pediatric patients presented with cardiovascular disease (CVD).
- Congenital heart disease (CHD) was prevalent (84%), with ventricular septal defect (28%) being the most common anomaly.
- Dilated cardiomyopathy (DCM) affected 16% of patients; 47% underwent surgery, and 16% died during follow-up.
Conclusions:
- Pediatric CVD in Djibouti is comparable in frequency to other African regions.
- Absence of surgical intervention emerged as a significant predictor of mortality.
- Further research is needed to elucidate genetic and environmental factors contributing to pediatric heart diseases in the Horn of Africa.
Introduction:
Few data are available about pediatric cardiovascular disease (CVD) in the Horn of Africa. The objective of this study was to describe the spectrum of CVD in children in Djibouti.
Methods:
Clinical features and management of Djiboutian children between 1 month-old and 15 year-old with CVD were prospectively recorded over a two-year period in Bouffard Military Hospital in Djibouti (January 2009- December 2010).
Results:
Clinical examination and echocardiography were performed on 156 patients: 32 of them (20%) had CVD. Three (10%) of them had Down's syndrome. The median age was 5 years (male 53%). Congenital heart disease was observed in 27 (84%) patients and dilated cardiomyopathy (DCM) in 5 (16%) patients including 2 patients with rheumatic valvular disease. Ventricular septal defect was frequent (28%). Other abnormalities were atrial septal defect (13%), Tetralogy of Fallot (9%), pulmonary stenosis (6%) and 3 other patients had multiple congenital anomalies condition. Surgical management was required in 22 (69%) patients and was performed on 15 (47%) cases. During follow up (mean 11.3 ± 6.8 months), 5 (16%) patients died. Absence of surgery was associated with significant mortality (p > 0.05) but age, sex and mean follow up were not.
Conclusion:
Pediatric CVD is at least as common in this Djiboutian community as in other African cohorts. The absence of surgery was a major mortality risk factor. DCM was frequent in this study. Much work remains to be done to discover the size and nature of genetic and environmental contributions to these various forms of heart diseases in the Horn of Africa.
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