Structural heart diseases among children seen at the Moi teaching and referral hospital: type and initial presentation

Abstract

Background: Structural heart diseases in young children and adolescents remain a significant contributor of disability and mortality in this age group and more so in developing countries. Their appropriate identification and diagnosis through echocardiography imaging, allows for the correct management to be instituted hence allow the child to have a near normal life.

Objectives: To determine the types of structural heart diseases diagnosed in children and to describe their clinical presentation at initial diagnosis

Design: Prospective study Setting: The Moi teaching and referral hospital (MTRH), Eldoret. Participants: A prospective cohort of newly diagnosed children recruited between July 2016 to July 2017.

Main outcome measures: The children’s social demographics, clinical presentations, types of cardiac lesions were determined. This article describes the initial presentation of this larger study.

Results: Out of the 154 participants recruited, 57.1% were female, and the median age was (IQR) 91(18,147), months. Regarding the type of cardiac lesion, 53% had congenital heart disease (CHD), while 47% had rheumatic heart disease (RHD). The commonest RHD lesion seen was mitral valve regurgitation (77.8%), while in the congenital heart disease category, it was patent ductus arteriosus (30.5%). In all the patients, 51.6% were asymptomatic when classified according to the Ross heart failure classification. On first encounter, 45.2% of patients were on frusemide, 74% of patients with RHD had already been commenced on benzathine penicillin.

Conclusion: RHD and CHD prevalence were equally distributed amongst this group, nearly 50% were asymptomatic and 74% of RHD patients were on monthly benzathine penicillin.