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Infective endocarditis in children with heart diseases at Jakaya Kikwete Cardiac Institute, Tanzania: a

Zawadi Edward Kalezi1,2,3, Alphonce Nsabi Simbila4,5, Deogratias Arnold Nkya6,7

  • 1Department of Paediatric Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania. ezawadi8@gmail.com.

BMC Pediatrics
|September 28, 2024
PubMed

Insights

Infective endocarditis (IE) in children with heart conditions has high in-hospital mortality. Heart failure and anemia were common, with acute kidney injury as a leading complication.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Infective endocarditis (IE) poses a severe threat to children with congenital or acquired heart conditions.
  • Outcomes for pediatric IE cases in cardiac centers are often underreported.
  • This study addresses the need for documented clinical profiles and treatment outcomes of pediatric IE at the Jakaya Kikwete Cardiac Institute (JKCI).

Purpose of the Study:

  • To document the clinical characteristics of children diagnosed with IE.
  • To evaluate the in-hospital treatment outcomes for pediatric IE patients.
  • To identify common presentations and complications of IE in this population.

Main Methods:

  • A hospital-based cross-sectional study with longitudinal follow-up was conducted.
  • Children diagnosed with IE according to the Modified Duke's Criteria were enrolled between November 2021 and November 2023.
  • Data on socio-demographics and clinical information were collected using a structured questionnaire.

Main Results:

  • Out of 1,546 admissions, 30 children with IE were studied, predominantly adolescents (53% aged 10-18 years).
  • Common symptoms included fever (40%), antibiotic use (47%), anemia (87%), and heart failure (70%).
  • Staphylococcus aureus was the most common pathogen (7/9 positive blood cultures); 33% developed acute kidney injury (AKI), and 37% died during hospitalization.

Conclusions:

  • In-hospital mortality for pediatric IE with underlying heart disease is notably high in this setting.
  • Heart failure and anemia are frequent clinical manifestations of IE in children.
  • Acute kidney injury (AKI) emerged as the primary non-cardiac complication during hospital stays.
Abstract

Keywords:
ChildrenHeart diseaseInfective endocarditisJKCITanzania

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