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Spectrum of heart diseases in children presenting to a paediatric cardiac echocardiography clinic in the Lake Zone of Tanzania: a 7 years overview.
BMC Cardiovascular Disorders ( IF 2.0 ) Pub Date : 2019-12-13 , DOI: 10.1186/s12872-019-01292-4
Antke Zuechner 1 , Tumaini Mhada 2 , Naizihijwa G Majani 3 , Godwin G Sharau 3 , William Mahalu 4 , Matthias W Freund 5
Affiliation  

BACKGROUND Congenital heart diseases (CHD) are among the most common congenital malformations. It is estimated that the incidence of CHD is constant worldwide, but data are rare for most African countries including Tanzania. Even less data are available on the prevalence of acquired heart diseases (AHD) in African children. Rheumatic heart disease (RHD) is the leading cause of AHD and is remaining a public health concern in Sub-Saharan Africa affecting especially the younger population. Both, CHD and AHD contribute substantially to morbidity and mortality during infancy and childhood. METHODS This hospital-based, retrospective review of the registry at the paediatric cardiac clinic of Bugando Medical Centre in the Lake Zone of Tanzania analysed the spectrum of heart diseases of paediatric patients during their first presentation by using simple descriptive statistics. RESULTS Between September 2009 and August 2016, a total of 3982 patients received cardiac evaluation including echocardiography studies. 1830 (46.0%) pathologic findings were described, out of these 1371 (74.9%) patients had CHD, whereas 459 (25.1%) presented with AHD. 53.9% of the patients with CHD were female and the most common associated syndrome was Down syndrome in 12.8% of patients. In 807 patients (58.9%) diagnosis of CHD was established within the first year of life. The majority of patients (60.1%) were in need of surgical or interventional therapy at time of diagnosis and 6.3% of patients were judged inoperable at the time of first presentation. Nearly 50% of cases with AHD were RHDs followed by dilated cardiomyopathy and pulmonary hypertension without underlying CHD. CONCLUSIONS The spectrum of CHD and AHD from one centre in Tanzania is comparable to findings reported in other countries from the African continent. Echocardiography is a valuable diagnostic tool and the widespread use of it should be enhanced to diagnose heart diseases in a large number and reasonable time. Most patients present late and majority is in need of surgical or interventional treatment, which is still not readily available. Untreated heart diseases contribute substantially to morbidity and mortality during infancy and childhood. Adequate cardiac services should be established and strengthened.

中文翻译:

坦桑尼亚湖区小儿心脏超声心动图诊所就诊儿童的心脏病谱:7年概述。

背景技术先天性心脏病(CHD)是最常见的先天性畸形。据估计,全球冠心病的发病率是恒定的,但是对于包括坦桑尼亚在内的大多数非洲国家而言,数据很少。关于非洲儿童后天性心脏病(AHD)患病率的数据甚至更少。风湿性心脏病(RHD)是AHD的主要原因,并且在撒哈拉以南非洲仍然是公共卫生问题,尤其影响到年轻人口。冠心病和AHD均对婴儿期和儿童期的发病率和死亡率做出了重大贡献。方法基于该医院,坦桑尼亚湖区Bugando医疗中心儿科心脏诊所对注册表的回顾性回顾通过使用简单的描述性统计数据分析了儿科患者首次就诊期间的心脏病谱。结果2009年9月至2016年8月,共有3982名患者接受了包括超声心动图检查在内的心脏评估。描述了1830例(46.0%)病理结果,其中1371例(74.9%)患有CHD,而459例(25.1%)患有AHD。53.9%的冠心病患者为女性,最常见的综合症是唐氏综合症,占12.8%。在807例患者中(58.9%),在生命的第一年内就确定了CHD的诊断。大多数患者(60.1%)在诊断时需要手术或介入治疗; 6。首次出现时,有3%的患者被判定为无法手术。几乎50%的AHD病例是RHD,随后是扩张型心肌病和肺动脉高压,而没有潜在的CHD。结论来自坦桑尼亚一个中心的冠心病和AHD谱图与非洲大陆其他国家报告的谱图相当。超声心动图是一种有价值的诊断工具,应扩大超声心动图的广泛应用范围,以在大量合理的时间内诊断出心脏病。多数患者到来较晚,多数患者需要手术或介入治疗,但仍不容易获得。未经治疗的心脏病在婴儿期和儿童期会大大增加发病率和死亡率。应建立并加强适当的心脏服务。
更新日期:2019-12-13
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