title: Spectrum of heart diseases in children: an echocardiographic study of 1,666 subjects in a pediatric hospital, Yaounde, Cameroon.
abstract: BACKGROUND
  Children's health programs in Sub-Saharan Africa have always been oriented primarily to infectious diseases and malnutrition. We are witnessing in the early 21(st) century an epidemiological transition marked by the decline of old diseases and the identification of new diseases including heart disease. Therefore, it is necessary to describe the spectrum of these diseases in order to better prepare health workers to these new challenges.
  
  
  METHODS
  We conducted a cross-sectional study focused on heart disease diagnosed by echocardiography in children seen from January 2006 to December 2014 in a pediatric hospital of Yaounde. We collected socio-demographic data and the types of heart disease from registers, patients files as well as the electronic database of echocardiographic records.
  
  
  RESULTS
  A total of 2,235 patients underwent echocardiographic examination during the study period including 1,666 subjects with heart disease. Congenital cardiopathies were found in 1,230 (73.8%) patients and acquired abnormalities in 429 (25.8%). Seven children (0.4%) had a combination of both types. Congenital heart defects (CHD) were dominated by ventricular septal defect (VSD). Acquired heart disease was mostly rheumatic valvulopathies. Dyspnea on exertion was the most frequent presenting complaint (87.6%). Discovery of a heart murmur was the principal clinical finding on physical examination (81.4%). The median age was 9 months for congenital heart disease and 132 months for acquired heart disease.
  
  
  CONCLUSIONS
  As infectious diseases recede and the diagnostic facilities are improving, pediatric heart diseases occupy a more important position in the spectrum of pediatric diseases in our context. However, the ability to evoke the diagnosis remains unsatisfactory by the majority of health personnel and therefore needs to be improved. Apart from congenital heart diseases, the impact of acquired heart diseases, rheumatic valvulopathy being the highest ranking, is remarkable in pediatrics. Awareness of health personnel for better management of child tonsillitis is more than ever a necessity. This preventive attitude of rheumatic heart disease is the main attitude available in our disadvantaged economic environment.
authors.affiliation: 1 Mother and Child Center of the Chantal Biya Foundation, Yaounde, Cameroon ; 2 Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon ; 3 Yaounde Gynecology, Obstetric and Pediatric Hospital, Yaounde, Cameroon ; 4 Cardiology Unit, Yaounde General Hospital, Yaounde, Cameroon ; 5 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon ; 6 Bangui Pediatric Complex, Bangui, Central Africa Republic.
authors.forename: David
authors.initials: D
authors.lastname: Chelo
authors.affiliation: 1 Mother and Child Center of the Chantal Biya Foundation, Yaounde, Cameroon ; 2 Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon ; 3 Yaounde Gynecology, Obstetric and Pediatric Hospital, Yaounde, Cameroon ; 4 Cardiology Unit, Yaounde General Hospital, Yaounde, Cameroon ; 5 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon ; 6 Bangui Pediatric Complex, Bangui, Central Africa Republic.
authors.forename: Félicitée
authors.initials: F
authors.lastname: Nguefack
authors.affiliation: 1 Mother and Child Center of the Chantal Biya Foundation, Yaounde, Cameroon ; 2 Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon ; 3 Yaounde Gynecology, Obstetric and Pediatric Hospital, Yaounde, Cameroon ; 4 Cardiology Unit, Yaounde General Hospital, Yaounde, Cameroon ; 5 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon ; 6 Bangui Pediatric Complex, Bangui, Central Africa Republic.
authors.forename: Alain P
authors.initials: AP
authors.lastname: Menanga
authors.affiliation: 1 Mother and Child Center of the Chantal Biya Foundation, Yaounde, Cameroon ; 2 Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon ; 3 Yaounde Gynecology, Obstetric and Pediatric Hospital, Yaounde, Cameroon ; 4 Cardiology Unit, Yaounde General Hospital, Yaounde, Cameroon ; 5 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon ; 6 Bangui Pediatric Complex, Bangui, Central Africa Republic.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Ngo Um
authors.affiliation: 1 Mother and Child Center of the Chantal Biya Foundation, Yaounde, Cameroon ; 2 Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon ; 3 Yaounde Gynecology, Obstetric and Pediatric Hospital, Yaounde, Cameroon ; 4 Cardiology Unit, Yaounde General Hospital, Yaounde, Cameroon ; 5 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon ; 6 Bangui Pediatric Complex, Bangui, Central Africa Republic.
authors.forename: Jean C
authors.initials: JC
authors.lastname: Gody
authors.affiliation: 1 Mother and Child Center of the Chantal Biya Foundation, Yaounde, Cameroon ; 2 Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon ; 3 Yaounde Gynecology, Obstetric and Pediatric Hospital, Yaounde, Cameroon ; 4 Cardiology Unit, Yaounde General Hospital, Yaounde, Cameroon ; 5 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon ; 6 Bangui Pediatric Complex, Bangui, Central Africa Republic.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Tatah
authors.affiliation: 1 Mother and Child Center of the Chantal Biya Foundation, Yaounde, Cameroon ; 2 Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon ; 3 Yaounde Gynecology, Obstetric and Pediatric Hospital, Yaounde, Cameroon ; 4 Cardiology Unit, Yaounde General Hospital, Yaounde, Cameroon ; 5 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon ; 6 Bangui Pediatric Complex, Bangui, Central Africa Republic.
authors.forename: Paul O
authors.initials: PO
authors.lastname: Koki Ndombo
keywords: Heart disease; Yaounde; acquired; child; congenital; diagnosis; echocardiography