@Article{chd.12529,
AUTHOR = {Felicit  e Kamdem, Danielle Kedy Koum, Ba Hamadou, Melanie Yemdji, Henry Luma, Marie Solange Doualla, Diomède Noukeu, Esther Barla, Christophe Akazong, Anastase Dzudie, Henry Ngote, Yves Monkam, Sidiki Mouliom, Samuel Kingue},
TITLE = {Clinical, echocardiographic, and therapeutic aspects of congenital heart diseases of children at Douala General Hospital: A cross-sectional study in sub-Saharan Africa},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {13},
YEAR = {2018},
NUMBER = {1},
PAGES = {113--117},
URL = {http://www.techscience.com/schd/v13n1/38939},
ISSN = {3071-1738},
ABSTRACT = {<b>Introduction:</b> Cardiovascular diseases in pediatric pathologies have emerged in the recent years in
sub-Saharan Africa (SSA), with congenital heart diseases (CHDs) being the most frequent. Unfortunately, their diagnosis is usually delayed, thereby increasing childhood morbidity and mortality.<br/>
<b>Objectives:</b> Describe the clinical, echocardiographic, and therapeutic aspects of CHDs of children
at Douala General Hospital.<br/>
<b>Methods:</b> We carried out a cross-sectional descriptive study over a 10-year period, from January
2006 to December 2015. Files and reports of cardiac ultrasounds of patients aged ≤ 15 years
were reviewed.<br/>
<b>Results:</b> We reviewed the medical records of 1616 children, of which 370 (22.9%) had CHD. The
age range was 1 day to 15 years, with a mean of 26 months. Heart murmur was the most frequent
clinical sign, seen in 72.3% of the cases. CHD with left-to-right shunt was seen in 61.8%, with
ventricular septal defect being the most common (29.8% of all cases). The second most common
CHDs were those due to obstruction (20.4%), mainly pulmonary stenosis (19.6% of all cases).
Cyanogenic CHDs accounted for 17.8% of cases, dominated by tetralogy of Fallot (7.4% of all
cases). Indications for surgical treatment was found in 171 (46.2%) patients, but due to financial
constraints, only 48 (28.1%) patients were operated. Among those who underwent surgery, 66.7%
were operated abroad, and Humanitarian organizations financed the surgical management of
58.3% of those operated.<br/>
<b>Conclusions:</b> CHDs are seen in one out of five children seen in the pediatric cardiology unit of our
Hospital for suspected heart disease. Most cases are diagnosed late in life as toddlers. The rate of
surgical correction remains low due to financial constraints, with most cases operated abroad with
the assistance of Humanitarian organizations.},
DOI = {10.1111/chd.12529}
}