title: Occurrence, aetiology and challenges in the management of congestive heart failure in sub-Saharan Africa: experience of the Cardiac Centre in Shisong, Cameroon.
abstract: BACKGROUND
  The aim of the study was to investigate the occurrence, the aetiology and the management of congestive heart failure in the cardiac centre of the St. Elizabeth catholic general hospital Shisong in Cameroon.
  
  
  METHODS
  Between November 2002 and November 2008, a population of 8121 patients was consulted in the referral cardiac centre of St. Elizabeth Catholic General Hospital. Of these patients, 462 were diagnosed with congestive heart failure according to the modified Framingham criteria for the diagnosis of heart failure. Complementary investigations used to confirm and establish the aetiology of the disease were the chest X-ray, electrocardiography, bi-dimensional Doppler echocardiography.
  
  
  RESULTS
  The results showed that the occurrence of congestive heart failure in our centre was 5.7%. Congestive heart failure was diagnosed in 198 females and 264 males, aged between 8 and 86 years old (42.5±18 years old). Post rheumatic valvulopathies (14.6%) and congenital heart diseases (1.9%) were the first aetiologic factor of congestive heart failure in the young, meanwhile cardiomyopathies (8.3%) in elderly followed by hypertensive cardiomyopathy (4.4%). Congestive heart failure was also seen in adults with congenital heart diseases in 0.01%. In this zone of Cameroon, we discovered that HIV cardiomyopathy (1.6%) and Cor pulmonale (8%) were represented, aetiological factors not mentioned in previous studies conducted in urban areas of Cameroon. The mean duration of hospital stay for the compensation treatment was thirteen days, ranging between 7 and 21 days), the mortality being 9.2%. All the medications recommended for the treatment of congestive heart failure are available in our centre but many patients are not compliant to the therapy or cannot afford them. Financial limitation is causing the exacerbation of the disease and premature death.
  
  
  CONCLUSIONS
  Our data show a high incidence of congestive heart failure mainly due to post rheumatic valvulopathies in young patients in our centre. National program to fight against rheumatic fever and complications are of great urgency in our country. The compensation treatment of congestive heart failure is challenging in our milieu, characterized by poor compliance and financial limitations.
authors: Cardiac Centre, St. Elizabeth Catholic General Hospital Shisong, Cameroon.
authors: Jacques Cabral
authors: JC
authors: Tantchou Tchoumi
authors: Jean Claude
authors: JC
authors: Ambassa
authors: Samuel
authors: S
authors: Kingue
authors: Alessandro
authors: A
authors: Giamberti
authors: Sylvia
authors: S
authors: Cirri
authors: Alessandro
authors: A
authors: Frigiola
authors: Gianfranco
authors: G
authors: Butera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications* / Q000453:epidemiology; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006349:Heart Valve Diseases / Q000150:complications* / Q000453:epidemiology; D006769:Hospitals, General; D006801:Humans; D007902:Length of Stay; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult