Pulmonary Hypertension in Children across Africa: The Silent Threat

Area of Science:

• Pediatric Cardiology
• Pulmonary Medicine
• Global Health

Background:

• Pulmonary hypertension (PH) in African children stems from unoperated congenital heart disease, rheumatic heart disease, infections, sickle cell anemia, and neonatal issues.
• Mortality from pulmonary arterial hypertension (PAH) is high in Africa, with 18-21% of patients dying within 6 months of diagnosis.
• PH is underreported in sub-Saharan Africa due to limited diagnostic capacity, particularly the lack of right heart catheterization.

Purpose of the Study:

• To highlight pediatric pulmonary arterial hypertension (PAH) as a consequence of significant healthcare gaps in Africa.
• To emphasize the urgent need for prevention strategies and research into the primary drivers of pediatric PAH on the continent.
• To underscore the importance of addressing preventable causes of PH in African children to reduce premature mortality.

Main Methods:

• This paper presents a review and analysis of existing data and clinical observations regarding pediatric PH in Africa.
• It synthesizes information on common causes, diagnostic challenges, and mortality rates.
• The focus is on identifying gaps in care and areas for future research and intervention.

Main Results:

• Unoperated congenital heart lesions and rheumatic heart disease are identified as major contributors to pediatric PH in Africa.
• Recurrent pulmonary infections and sickle cell anemia also play significant roles.
• High mortality rates and underreporting underscore the severity and neglect of the condition.

Conclusions:

• Pediatric PAH in Africa is largely attributable to preventable conditions and significant gaps in healthcare.
• There is a critical need to improve diagnostic capabilities and implement targeted prevention programs.
• Further research into the specific drivers of pediatric PH in Africa is essential to combat premature mortality.