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Heart Failure in Ethiopian Children: Mirroring the Unmet Cardiac Services
Bezaye Nigussie1, Henok Tadele1
1College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Insights
Pediatric heart failure (HF) in Ethiopia is primarily caused by structural heart disease, with rheumatic and congenital conditions being most common. This study highlights HF
Area of Science:
- Pediatric Cardiology
- Global Health
- Clinical Epidemiology
Background:
- Heart failure (HF) is a significant clinical syndrome with limited research in Sub-Saharan Africa, particularly Ethiopia.
- Understanding the patterns and outcomes of pediatric HF is crucial for improving healthcare in the region.
Purpose of the Study:
- To describe the pattern and outcomes of pediatric heart failure (HF) at a referral-teaching hospital in Ethiopia.
- To identify the common causes and precipitating factors of HF in children.
Main Methods:
- A retrospective review of medical records for 216 children diagnosed with HF between January 2014 and January 2016.
- Data analysis included descriptive statistics presented in tables and pie charts.
Main Results:
- Heart failure (HF) constituted 10.8% of pediatric admissions, with structural heart disease (rheumatic and congenital) as the leading cause.
- Congenital heart disease (CHD) was more prevalent in children under 5 years, while rheumatic heart disease (RHD) affected older children.
- The case fatality rate for pediatric HF was 13.9%, with pneumonia and infective endocarditis as common comorbidities.
Conclusions:
- Structural heart disease is the primary driver of pediatric heart failure (HF) in this Ethiopian setting.
- Targeted echocardiographic screening and optimized management for structural heart disease are recommended.
- Addressing HF in children requires a focus on underlying etiologies like CHD and RHD.
Background:
HeartFailure (HF) is a progressive clinical and pathophysiological syndrome caused by cardiovascular and noncardiovascular abnormalities. Childhood HF has not been well studied in Sub-Sharan Africa, particularly in Ethiopia. Hence, this study aimed at describing the pattern and outcome of pediatrics HF at a referral-teaching hospital.
Methods:
Medical records of 216 HF children aged 2 months to 14 years, and admitted between January 2014 and January 2016 were reviewed. Clinical information was collected, analyzed and presented in tables and pie charts.
Results:
A total of 2000 children were admitted to Hawassa University Hospital during the study period. HF accounted for 10.8% (216) of pediatrics admissions, 51.9% males. The median age of the study subjects was 6 years. Functionally, NYHA/Ross class III and IV consisted 65(30.1%) and 139(64.4%) of HF. Structural heart disease was the commonest cause of HF, 144(66.7%): Rheumatic heart disease (RHD),75(52%), and congenital heart disease (CHD),64(44.5%). Anemia and renal cases contributed to 50(23.1) and 12(5.6%) of HF.CHD was predominantly documented in <5 years. Pneumonia 66(42.9%), and infective endocarditis 29(18.8%) were the common precipitating/comorbid conditions with HF. The case fatality rate of HF was 13.9 %(30).
Conclusion:
In this study, HF accounted for a tenth of pediatrics admissions. Structural heart disease was the commonest cause of heart failure. CHD and RHD affected predominantly children of <5 years of age and >5 years of age. Echocardiographic screening of HF cases for structural heart disease and optimal care for patients with underlying structural heart disease are recommended.
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