Study of The Cardiac Function of Children Aged from 6 to 59 Months Suffering from Severe Acute Malnutrition in Yaounde Cameroon

Abstract

Background: Malnutrition is a real public health problem in developing countries. The prevalence remains high in Cameroonian. Context: This condition is regularly accompanied by organ failure. One of the most frequent and severe situations is cardiac involvement with implications on the management of patients. Describing the echocardiographic abnormalities of the heart function of children aged 6 to 59 months hospitalized for Severe Acute Malnutrition (SAM) in the hospitals of Yaoundé was the goal of this study. Knowledge of changes in heart function during the management of SAM will contribute to ameliorating the prognosis, which will also depend on the cardiac lesions. Methods: It was a cross sectional descriptive study carried out in healthcare structures in the town of Yaoundé for a period of 5 months, from January to May 2015. Children aged 6 to 59 months suffering from severe acute malnutrition and hospitalized for at least 6 days were included. We excluded those who had a pathology which could influence heart function. Data collected covered the sociodemographic, clinical and echocardiographic characteristics of the study participants. Results: Most of the 78 children recruited were less than 18 months old (81.08%). The sex ratio was 0.6. Marasmus was the most common type of SAM we found (78.38%). Concerning echocardiography, 35.14% of children had a left ventricular shortening fraction (LVSF) and a Left Ventricular Ejection Fraction (LVEF) less than the 3rd percentile. In all the patients, the speed of the E and A waves was less than -2SD of reference means. The ratio of the E/A waves was less than the 5thpercentile in 35.14%. All had a Tricuspid Annular Plane Systolic Excursion (TAPSE) <-2SD of the reference mean. The decrease of the LVEF was significantly linked to the young age of the patients and to the degree of severity of the malnutrition. Conclusion: severe acute malnutrition is associated with both systolic and diastolic heart failure. Functions of the two ventricles are altered. The severity of heart lesion depends on the degree of malnutrition.