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Paediatric dilated cardiomyopathy in Khartoum state, Sudan: a prospective study
Osama Hafiz Elshazali1, Ekhlas Abdalla2
1Department of Paediatrics and Child Health, University of Khartoum Faculty of Medicine, Khartoum, Sudan.
Insights
Paediatric dilated cardiomyopathy (DCM) is a serious heart condition in Sudanese children. This study found a high incidence and mortality rate, highlighting the urgent need for improved healthcare systems to manage this disease.
Area of Science:
- Cardiology
- Paediatric Medicine
- Epidemiology
Background:
- Dilated cardiomyopathy (DCM) is a significant heart muscle disease affecting children, potentially leading to heart failure and death.
- There is a critical lack of epidemiological data on paediatric DCM in Sudan and sub-Saharan Africa.
- Understanding the scope of paediatric DCM is crucial for developing targeted interventions.
Purpose of the Study:
- To determine the incidence of DCM in children within Khartoum state, Sudan.
- To identify the primary causes and common presentations of paediatric DCM.
- To evaluate the outcomes and mortality associated with DCM in this population.
Main Methods:
- A prospective, cross-sectional study was conducted over six months in three paediatric hospitals in Khartoum state, Sudan.
- Data were collected on 55 children diagnosed with DCM.
- Incidence, etiological factors, clinical presentation, echocardiographic findings, and patient outcomes were analyzed.
Main Results:
- The incidence of DCM in Khartoum was 1.4 cases per 100,000 children annually, with a 1.9:1 female to male ratio.
- Post-viral (49%) and idiopathic (45%) causes were most common; shortness of breath (97%) was the primary symptom.
- A high mortality rate of 65% was observed, with 15% recovery and 20% static conditions.
Conclusions:
- Paediatric DCM in Sudan exhibits a high incidence and mortality rate, exceeding that of middle- and high-income countries.
- Urgent improvements in the healthcare system are necessary to effectively address and manage DCM in Sudanese children.
- Further research into aetiology and prevention strategies is warranted.
Background:
Dilated cardiomyopathy (DCM) is a disease of the heart muscle that affects ventricular function; it is a debilitating disease that can lead to heart failure and death in children. There is a lack of good epidemiological data about paediatric DCM in Sudan or in sub-Saharan Africa.
Objective:
To study the incidence, causes and outcome of DCM among children in Sudan.
Methods:
A prospective cross-sectional study that was conducted in three paediatric hospitals in Khartoum state, Sudan over the period of 6 months.
Results:
During the study period, 55 children were seen with the diagnosis of DCM; The female: male ratio was 1.9:1. The incidence of DCM in Khartoum state was found to be 1.4 cases per 100 000 children per year, 10 children (18 %) were diagnosed in the first year of their life. Twenty-seven children (49 %) showed evidence of failure to thrive, being below the fifth percentile for weight. The most common cause of DCM was found to be postviral in 27 children (49%), followed by Idiopathic in 25 children (45%). The most common presentation was the shortness of breath in 53 children (97%), on echocardiography 26 children (47 %) showed evidence of severe left ventricular impairment and 23 children (42%) showed moderate ventricular impairment. Regarding the outcome, 8 children (15%) recovered, the condition of 11 children (20%) remained static and there were 36 deaths (65%).
Conclusion:
The incidence of DCM in Sudanese children was found to high with a higher mortality compared with middle-income and high-income countries; Improvement in the entire health system is needed to tackle this condition.
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