Heart failure in Nigerian children

Abstract

Heart failure is an important cause of morbidity and mortality among children. There are very few reports on heart failure among the children living in developing countries. This informed the decision to study heart failure among the children at the hospital. The objectives of this study were to determine how common heart failure is its aetiologies and contribution to morbidity and mortality in childhood. The study was prospective in design and was carried out on consecutive children presenting with heart failure between 1st of April and the 30th of September 2007 at the paediatric emergency unit of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. A total 391 children presented at the paediatric emergency in this 6 months period. Of the 391 subjects, 35 (9.0%) presented with heart failure. The 35 children consisted of 21 boys and 14 girls giving a male to female ratio of 1.5:1. The age range of the children studied was between 1 month and 13 years and the mean age was 3.1+/-3.5 years. Total 13 (37.1%) children were in the age range 1 month to 1 year while 15 (42.7%) were aged between >1-5 years and 7 were aged >5-12 years. Anaemia, bronchopneumonia, lobar pneumonia, ventricular septal defect, transposition of the great arteries, acute glomerulonephritis, rheumatic fever, myocarditis and septicemia were identified as causes in 57.1, 28.6, 8.6, 2.9, 2.9, 2.9 and 2.9% of cases, respectively. Most cases of aneamic heart failure were due to malaria. Of the 28 children aged below 5 years, pneumonia and malaria induced aneamia was responsible for CCF in 26 (92.9%) compared with the equivalent 3 (42.9%) amongst the total 7 subjects aged over 5 years. This difference is statistically significant, p = 5.52, chi2 = 0.02, Yate's correction applied. The average number of hospitalization days was 3.2 and 6.2 for patients with heart failure secondary to anaemia and pneumonia, respectively. Of the 35 children studied 29 (82.9%) had good recovery, 3 (8.6%) died, 2 (5.7%) were discharged against medical advice and one (2.9%) was referred to the university college hospital for further management. © Medwell Journals, 2010.