© 1982 by Oxford University Press
research-article |
Acquired Heart Disease in Nigerian Children: An Illustration of the Influence of Socio-Economic Factors on Disease Pattern
University of Ibadan Nigeria
A study of acquired heart disease in 240 Nigerian children aged from birth to 15 years revealed that the commonest types were rheumatic heart disease (35.8% of cases), infective pericarditis (26.7%), endomyocardial fibrosis (21.7%) and congestive cardiomyopathy (11.2%). Hypertensive heart disease, endocardial fibroelastosis, and cor pulmonale were rare. 95% of the patients with rheumatic heart disease had mitral incompetence, either alone or in combination with other lesions. Other noteworthy features of the disease included its multivalvular involvement (31% of cases), early onset of significant mitral stenosis, severe morbidity (95% presented in heart failure) and a high mortality (20%). Infective pericarditis was sequel to septicaemia or pulmonary infection in a majority of cases, and precipitated heart failure in 33% of the patients. Unlike in congestive cardiomyopathy, where improvement was sometimes observed, endomyocardial fibrosis was invariably associated with progressive cardiac decompensation.
Most of the diseases appear to be attributable to some antecedent bacterial or parasitic infections; and ignorance, poverty and scarcity of health facilities contributed appreciably to their considerable morbidity and mortality.