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Pattern of congestive heart failure in a Kenyan paediatric population
Julius A Ogeng'o1, Patrick M Gatonga, Beda O Olabu
1Department of Human Anatomy, University of Nairobi, Nairobi, Kenya.
Insights
Congestive heart failure (CHF) is common in Kenyan children, primarily affecting those under five and more boys than girls. Infections, anemia, and rheumatic heart disease are leading causes, with most children recovering after treatment.
Area of Science:
- Pediatric Cardiology
- Public Health
- Epidemiology
Background:
- Pediatric heart failure presents a significant global health challenge, impacting child morbidity and mortality.
- Data on pediatric heart failure patterns in Africa are scarce, hindering targeted interventions.
- Understanding regional variations is crucial for effective management and prevention strategies.
Purpose of the Study:
- To investigate the epidemiological characteristics of congestive heart failure in Kenyan children.
- To identify the primary causes, diagnostic methods, and treatment outcomes for pediatric heart failure in Kenya.
Main Methods:
- Retrospective analysis of 158 pediatric patient records (aged ≤12 years) at Kenyatta National Hospital from 2006-2010.
- Data collected included diagnosis methods, patient demographics, etiology, treatment, and outcomes.
- Statistical analysis performed using SPSS v.16.0, with results presented visually.
Main Results:
- The study analyzed 158 cases (91 male, 67 female) with a mean age of 4.7 years, peaking between 1-3 years.
- Infection (22.8%), anemia (17.1%), rheumatic heart disease (14.6%), and congenital heart disease (13.3%) were the most common causes.
- A recovery rate of 77.9% was observed, with 13.9% recovering after surgery; mortality was 7.6%.
Conclusions:
- Congestive heart failure is prevalent in Kenyan children, predominantly affecting those under five and males.
- Infectious agents, anemia, and rheumatic/congenital heart diseases are key etiologies, differing from developed nations.
- Prompt infection control and anemia management are recommended for improved pediatric heart failure outcomes.
Background:
Heart failure in children is a common cause of morbidity and mortality, with high socio-economic burden. Its pattern varies between countries but reports from Africa are few. The data are important to inform management and prevention strategies.
Objective:
To describe the pattern of congestive heart failure in a Kenyan paediatric population.
Methods:
This was a retrospective study done at Kenyatta National Hospital, Nairobi Kenya. Records of patients aged 12 years and younger admitted with a diagnosis of heart failure between January 2006 and December 2010 were examined for mode of diagnosis, age, gender, cause, treatment and outcome. Data were analysed using the Statistical Programme for Social Scientists version 16.0 for windows, and presented in tables, bar and pie charts.
Results:
One hundred and fifty-eight cases (91 male, 67 female) patients' records were analysed. The mean age was 4.7 years, with a peak at 1-3 years. The male: female ratio was 1.4:1. All the cases were in New York Heart Association (NYHA) class II-IV. Evaluation of infants was based on the classification proposed by Ross et al. (1992). Diagnosis was made based on symptoms and signs combined with echocardiography (echo) and electrocardiography (ECG) (38%); echo alone (12.7%); ECG, echo and chest X-ray (CXR) (11.4%); and ECG alone (10.8%). The underlying cause was established on the basis of symptoms, signs, blood tests, CXR, echo and ECG results. Common causes were infection (22.8%), anaemia (17.1%), rheumatic heart disease (14.6%), congenital heart disease (13.3%), cardiomyopathy (7.6%), tuberculosis and human immunodeficiency virus (6.9% each); 77.9% of patients recovered, 13.9% after successful surgery, and 7.6% died.
Conclusion:
Congestive heart failure is not uncommon in the Kenyan paediatric population. It occurs mainly before five years of age, and affects boys more than girls. The majority are due to infection, anaemia, and rheumatic and congenital heart diseases. This differs from those in developed countries, where congenital heart disease and cardiomyopathy predominate. The majority of children usually recover. Prudent control of infection and correction of anaemia are recommended.
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