Rheumatic valve disease in children still a burden in sub-Saharan Africa: Diagnostic, therapeutic and prognostic aspects in two hospitals in Central Africa subregion

Abstract

Introduction

Rheumatic fever remains a public health problem in sub-Saharan Africa. Its impact on the heart valves is the main acquired cardiopathy in children in our environment.

Objective

The aim of our study was to investigate the diagnostic, therapeutic and prognostic aspects of rheumatic heart valve disease in children aged 0–18 years in two hospitals in the city of Yaoundé.

Methods

We conducted a cross-sectional analytical study with retrospective and prospective data collection over a 5-years period (2018–2023). All patients aged 0 to 18 years with an echocardiographically confirmed diagnosis of rheumatic valvulopathy in the cardiology departments of the Chantal Biya Foundation and the Yaoundé Central Hospital were included. We collected sociodemographic, clinical, paraclinical, therapeutic and outcome data.

Results

We recruited 106 patients, predominantly female (65.8%); mean age was 11.4 ± 3 (4–18) years. The most common age group was 10 to 14 years (63.2%). Promiscuity (86.8%) and recurrent sore throat (68.4%) were the most common findings in the past history. Monovalvular involvement (mainly mitral valve) predominated in 60.5% of cases. The proportion of deaths in the population was 7.9%. After multivariate analysis, only the presence of cardiac liver and oedema of the lower limbs increased the risk of having a poor prognosis (OR > 1; P < 0.05).

Conclusion

The eradication of rheumatic valve disease in children necessarily involves early-prevention. This would involve cleaning up the living environment to prevent streptococcal infections and improving sociodemographic conditions.