1
|
Al-Fahham MM, Ali YA. Pattern of congenital heart disease among Egyptian children: a 3-year retrospective study. Egypt Heart J 2021; 73:11. [PMID: 33512632 PMCID: PMC7846646 DOI: 10.1186/s43044-021-00133-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Congenital heart disease (CHD) is a multifactorial birth defect which has variable demographic characteristics among children in different geographical areas. This study aimed to detect the distribution of demographic data, perinatal risk factors, types, age, and mode of presentation of CHD among Egyptian children. RESULTS The medical records of 1005 patients were included. They were 545 males (54%) and 462 females (46%) with a ratio of 1.2:1. Acyanotic CHD was encountered in 79.2%. Isolated ventricular septal defect and tetralogy of Fallot were the most common acyanotic and cyanotic lesions, respectively. The majority was diagnosed within the first year of life (86.7%) and was born to young mothers (91.3%). The accidental discovery of a murmur was the most frequent presentation (35%). Heart failure was detected in 44%, audible murmurs in 74.4%, maternal illnesses in 54%, consanguinity in 44.6%, prematurity in 19.3%, assisted reproduction in 11.7%, family history of CHD in 9.2%, abortions in 7.1%, and extracardiac anomalies in 3.6% of the studied population. Down syndrome (DS) was the most commonly occurring chromosomal anomaly, and the atrioventricular septal defect was the most characteristic cardiac lesion found among them. CONCLUSIONS There is no sex predilection among Egyptian children with CHD. Most of the cases are diagnosed in early infancy. Accidental discovery of a murmur is the most common mode of presentation. A variety of predisposing risk factors are abundant in the Egyptian population. DS is the most common chromosomal anomaly linked to CHD. Establishment of a national medical birth registry containing all information about all births in Egypt is needed for adequate surveillance and monitoring of perinatal health problems and congenital birth defects so that preventive measures can be early implemented. Proper and detailed data collection should be fulfilled in the medical records of every single patient.
Collapse
Affiliation(s)
- Marwa Moustapha Al-Fahham
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. .,Al-Salam International Hospital/Doctor Residency Building, P.O. Box 11023, Bneid Al Gar, Kuwait.
| | | |
Collapse
|
2
|
Saleh NY, Salem SS, Abo-El Fotoh WM, Soliman SE, Abo-Haded HM. Angiotensin-converting enzyme insertion/deletion (ACE I/D) gene polymorphism in Egyptian children with congenital heart disease. Birth Defects Res 2020; 112:963-969. [PMID: 32343056 DOI: 10.1002/bdr2.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/16/2020] [Accepted: 04/04/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Congenital heart diseases (CHDs) are the leading cause of infant deaths worldwide. The relationship between angiotensin-converting enzyme (ACE) gene polymorphism and CHDs is not clear. The aim of this work is to assess the presence of an association between ACE I/D polymorphism and CHD in Egyptian population. SUBJECTS AND METHODS Seventy CHD cases and 70 controls were incorporated in this study. DNA was isolated from their peripheral blood, and then ACE I/D gene polymorphism was tested by polymerase chain reaction (PCR). RESULTS There was no significant difference among the frequencies of the DD, II, and DI genotypes in patients and controls (26 [37.1%], 37 [53.3%], and 4 [5.7%], 5 [6.7%]), 40 (57.2%), 28 (40%), respectively (p value = 1 and OR [95% CI] = 1.1). There was no significant difference between D allele (DD + DI) and II genotype distribution among patients and controls (p value = 1 and OR [95% CI] = 1.2 [0.3-2.9]). Moreover, there was no difference between I allele (II + DI) and DD frequency (p value = 0.2 and OR [95% CI] = 0.6 [0.3-1.2]). CONCLUSIONS ACE I/D gene polymorphism might not be a risk factor of CHD in Egyptian children. Additional widespread studies are needed to affirm these data.
Collapse
Affiliation(s)
- Nagwan Y Saleh
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Sherif S Salem
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Wafaa Mm Abo-El Fotoh
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Shaimaa E Soliman
- Department of Medical Biochemistry, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt.,Medical Biochemistry Unit, Pathology Department, Faculty of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Hany M Abo-Haded
- Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| |
Collapse
|
3
|
Ekure EN, Sokunbi O, Kalu N, Olusegun-Joseph A, Kushimo O, Amadi C, Hassan O, Ikebudu D, Onyia S, Onwudiwe C, Nwankwo V, Akinwunmi R, Awusa F, Akere Z, Dele-Salawu O, Ajayi E, Ale O, Muoneke D, Muenke M, Kruszka P, Beaton A, Sable C, Adeyemo A. Congenital heart disease in school children in Lagos, Nigeria: Prevalence and the diagnostic gap. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2020; 184:47-52. [PMID: 32052942 DOI: 10.1002/ajmg.c.31779] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 01/30/2020] [Accepted: 02/04/2020] [Indexed: 02/04/2023]
Abstract
Congenital heart disease (CHD) in low-and-middle income countries (LMIC) is often characterized by late presentation resulting from inadequate screening and healthcare access in these regions. Accurate estimates of the burden of CHD among school children are often lacking. The objective of this study was to determine the prevalence and distribution of CHD among school children in two communities (urban and semi-urban) in south western Nigeria. Using clinical assessment and portable echocardiography, 4107 school children aged 5 years to 16 years in Lagos, Nigeria, were selected using a multistage sampling procedure and screened for CHD. Diagnosis of CHD was made after echocardiography. Children identified with CHD were referred to a tertiary hospital for appropriate cardiac care. The 4,107 children screened had a mean age of 11.3 ± 2.7 years and 53.7% were females. Twenty seven children had echocardiography-confirmed CHD, representing a prevalence of CHD among school children in Lagos, Nigeria of 6.6 per 1000 children. Acyanotic CHD constituted 96.3% of detected cases. Two children diagnosed with CHD (Tetralogy of Fallot and severe pulmonary valve stenosis respectively) had successful intervention. The prevalence of previously undiagnosed CHD among school children in Lagos Nigeria is substantial and highlights gaps in the health care system and school health programs. Echocardiographic screening of school children provides an opportunity for missed early diagnosis and treatment of CHD and reduces the prevalence of first-diagnosed CHD in adulthood. Therefore, focused clinical examination of school children followed by echocardiography is a strategy that could bridge this diagnostic and treatment gap in CHD.
Collapse
Affiliation(s)
- Ekanem N Ekure
- Department of Pediatrics, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Ogochukwu Sokunbi
- Department of Pediatrics, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Nnenna Kalu
- Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Akinsanya Olusegun-Joseph
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oyewole Kushimo
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Casmir Amadi
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Olayinka Hassan
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Desmond Ikebudu
- Central Research Laboratory, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Sophia Onyia
- Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Chinonso Onwudiwe
- Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Victor Nwankwo
- Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Remi Akinwunmi
- Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Fukpode Awusa
- Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Zainab Akere
- Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Olaolu Dele-Salawu
- Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Elizabeth Ajayi
- Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Olagoke Ale
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Dorothy Muoneke
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Maximillian Muenke
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Paul Kruszka
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Andrea Beaton
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Craig Sable
- Children's National Medical Center, Washington, District of Columbia
| | - Adebowale Adeyemo
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
4
|
Gundogdu Z, Babaoglu K, Deveci M, Tugral O, Zs U. A Study of Mortality in Cardiac Patients in a Pediatric Intensive Care Unit. Cureus 2019; 11:e6052. [PMID: 31827987 PMCID: PMC6890153 DOI: 10.7759/cureus.6052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE One of the major causes of mortality in the pediatric intensive care unit (PICU) is heart disease. This study aimed to determine the causes of mortality in children with pre-existing cardiac abnormalities who were admitted into the PICU. METHODS Data were collected through patient profile assessment and outcome and heart diseases affecting prognosis were analyzed. Medical records of children were reviewed retrospectively. The updated Pediatric Index of Mortality 2 (PIM2) scores were used. Exploratory data analysis was performed using descriptive measures. Kolmogorov-Smirnov tests were used to test the normality of data distribution. RESULTS Out of 566 admissions into PICU, 76 (13.4%) had cardiac abnormalities. Median and range of PICU stay were 5.50 and 417.88 days. The mean PIM2 score on admission was found to be 31.05. The most common admission was due to atrioventricular septal defect (AVSD) (15.7%), cardiomyopathy (13.1%), ventricular septal defect (VSD) (11.8%), tetralogy of Fallot (10.5%) and others (48.9%). There were multiple cardiac anomalies in 3.9% of patients. The most important cause of cardiac mortality in PICU was septic shock (26.0%) followed by cardiogenic shock (20.6%), and cardiac failure (13.7%). The nosocomial infection rate of cardiac patients in PICU was 10.5%. CONCLUSIONS Our study reconfirmed that the PIM2 score is a good indicator of cardiac diseases. Infections, nosocomial infections, pneumonia, and septic shock were the leading causes of mortality in cardiac patients. Better infection control in the PICU may have a significant impact on decreasing mortality rates.
Collapse
Affiliation(s)
| | | | | | - Okan Tugral
- Cardiology, Kocaeli University, Kocaeli, TUR
| | - Uyan Zs
- Pediatrics, Kocaeli University, Kocaeli, TUR
| |
Collapse
|
5
|
Susan UA, Nnena TP, Edewele OB. Prevalence of congenital heart diseases among primary school children in the Niger Delta Region of Nigeria, West Africa. ACTA ACUST UNITED AC 2019. [DOI: 10.29328/journal.jccm.1001056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
6
|
Edwin F, Elgamal MA, Dorra A, Reddy D, Entsua-Mensah K, Adzamli I, Yao NA, Tettey M, Tamatey M, Vosloo S, Kinsley R. Challenges of Caring for Functionally Single Ventricle Patients in Africa. World J Pediatr Congenit Heart Surg 2019; 10:338-342. [PMID: 31084309 DOI: 10.1177/2150135118817769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Surgical palliation has remarkably improved survival of functionally single ventricle (FSV) patients born in developed nations but such outcomes have not occurred in Africa. The poor care coverage for FSV patients in Africa exists within the larger sphere of deficient health care for children born with congenital heart defects (CHDs) in Africa generally. This review takes the position that to improve health-care coverage for CHD patients on the continent, political priority is paramount. This can be attained with cohesive leadership for the CHD agenda, a guiding institution, and the mobilization of civil society to drive advocacy at national and international levels.
Collapse
Affiliation(s)
- Frank Edwin
- 1 Department of Surgery, University of Health and Allied Sciences, Ho, Ghana.,2 National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Abid Dorra
- 4 Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - Darshan Reddy
- 5 Department of Cardiothoracic Surgery, University of Kwa-Zulu Natal, Durban, South Africa.,6 Lenmed Ethekwini Hospital and Heart Centre, Durban, South Africa
| | - Kow Entsua-Mensah
- 2 National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Innocent Adzamli
- 2 National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Nana-Akyaa Yao
- 2 National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Mark Tettey
- 2 National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Ghana.,7 School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Martin Tamatey
- 1 Department of Surgery, University of Health and Allied Sciences, Ho, Ghana.,2 National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Susan Vosloo
- 8 Christiaan Barnard Memorial Hospital, Cape Town, South Africa
| | - Rob Kinsley
- 6 Lenmed Ethekwini Hospital and Heart Centre, Durban, South Africa
| |
Collapse
|
7
|
The prevalence of unrecognized congenital heart disease among healthy elementary school students in northern Thailand. ASIAN BIOMED 2018. [DOI: 10.2478/abm-2010-0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Background: Congenital heart disease (CHD) is one of the major congenital anomalies among newborns. Although many infants with CHD are symptomatic and identified soon after birth, others remain undiagnosed until the disease becomes severe. Objectives: Unravel the number of CHD cases among 7-12 years old students who reported neither clinical complication nor history about cardiac diseases, stressing the importance for regular cardiac examination in children, even if they appeared healthy. Methods: The study selected students without clinical history of heart disease from 1,041 elementary schools in northern Thailand (Tak, Nakhon Sawan and Uttaradit). Certified nurses and health officers examined the students for abnormal heart conditions. Pediatric cardiologists scrutinized the students with suspected CHD for confirmation and characterization of cardiac lesion types. Results: Out of 144,293 students included in the study, 851 students showed atypical heart symptoms, and 87 were verified to have the CHD. This conferred the prevalence rate of unrecognized CHD among the elementary school children to be 0.60 per 1,000. The frequently-detected heart defects were ventricular septal defect (41.4%) and pulmonary stenosis (16.1%). Fifty-one children (58.6%) required surgery for cardiovascular correction. The prevalence of the CHD in elementary school students ranged from 0.41 to 1.05 cases per 1000 study subjects. The greatest number of incidences was found in Tak province where medical resources are inadequate. Conclusion: This study highlights the significance of routine cardiac examination among school-aged students, particularly in the regions with limited medical facilities, providing information essential for appropriate health care planning and managements.
Collapse
|
8
|
Kotby AA, Al-Fahham MM, Elabd HSA, Zaki OK. Prevalence of congenital heart defects among 54 Egyptian children with Maple syrup urine disease. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2018. [DOI: 10.1016/j.ejmhg.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
9
|
Keates AK, Mocumbi AO, Ntsekhe M, Sliwa K, Stewart S. Cardiovascular disease in Africa: epidemiological profile and challenges. Nat Rev Cardiol 2017; 14:273-293. [PMID: 28230175 DOI: 10.1038/nrcardio.2017.19] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
From a global perspective, the large and diverse African population is disproportionately affected by cardiovascular disease (CVD). The historical balance between communicable and noncommunicable pathways to CVD in different African regions is dependent on external factors over the life course and at a societal level. The future risk of noncommunicable forms of CVD (predominantly driven by increased rates of hypertension, smoking, and obesity) is a growing public health concern. The incidence of previously rare forms of CVD such as coronary artery disease will increase, in concert with historically prevalent forms of disease, such as rheumatic heart disease, that are yet to be optimally prevented or treated. The success of any strategies designed to reduce the evolving and increasing burden of CVD across the heterogeneous communities living on the African continent will be dependent upon accurate and up-to-date epidemiological data on the cardiovascular profile of every major populace and region. In this Review, we provide a contemporary picture of the epidemiology of CVD in Africa, highlight key regional discrepancies among populations, and emphasize what is currently known and, more importantly, what is still unknown about the CVD burden among the >1 billion people living on the continent.
Collapse
Affiliation(s)
- Ashley K Keates
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000, Australia
| | - Ana O Mocumbi
- Instituto Nacional de Saúde, Ministério da Saúde, Av. Eduardo Mondlane/Salvador Allende Caixa Postal 264, Maputo, Moçambique
| | - Mpiko Ntsekhe
- Division of Cardiology, Department of Medicine, University of Cape Town, Old Main Building, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa
| | - Karen Sliwa
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000, Australia
- Hatter Institute for Cardiovascular Research in Africa, Cape Heart Centre, 4th floor Chris Barnard Building, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Simon Stewart
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000, Australia
- Hatter Institute for Cardiovascular Research in Africa, Cape Heart Centre, 4th floor Chris Barnard Building, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa
| |
Collapse
|
10
|
Mazen I, Amin H, Kamel A, El Ruby M, Bignon-Topalovic J, Bashamboo A, McElreavey K. Homozygous Mutation of the FGFR1 Gene Associated with Congenital Heart Disease and 46,XY Disorder of Sex Development. Sex Dev 2016; 10:16-22. [PMID: 27055092 DOI: 10.1159/000444948] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Indexed: 11/19/2022] Open
Abstract
Congenital heart diseases (CHDs) are the most common cause of all birth defects and account for nearly 25% of all major congenital anomalies leading to mortality in the first year of life. Extracardiac anomalies including urogenital aberrations are present in ∼30% of all cases. Here, we present a rare case of a 46,XY patient with CHD associated with ambiguous genitalia consisting of a clitoris-like phallus and a bifid scrotum. Exome sequencing revealed novel homozygous mutations in the FGFR1 and STARD3 genes that may be associated with the phenotype.
Collapse
Affiliation(s)
- Inas Mazen
- Department of Clinical Genetics, National Research Center, Cairo, Egypt
| | | | | | | | | | | | | |
Collapse
|
11
|
Amel-Shahbaz S, Behjati-Ardakani M, Namayandeh SM, Vafaeenasab M, Andishmand A, Moghimi S, Negahdary M, Sarebanhassanabadi M. The epidemiological aspects of congenital heart disease in central and southern district of Iran. Adv Biomed Res 2014; 3:233. [PMID: 25538919 PMCID: PMC4260289 DOI: 10.4103/2277-9175.145732] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 07/27/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Congenital heart disease (CHD) is a major health problem and its prevalence is different around the world. The aim of study was determination of the epidemiological aspects of CHD in central and southern district of Iran. MATERIALS AND METHODS In this descriptive and analytical study, 3714 medical records were evaluated from March 21, 2001 to December 18, 2011. Medical records of inpatients from angiography and outpatients in the Heart Clinic of Afshar hospital (a referral hospital in center and south of Iran) were the source of information. Types of CHD and demographic data including age, sex and residential location are collected. The data were analyzed by SPSS (version 17) software. Chi-square and Fisher's exact tests were used to compare variables between groups. RESULTS At the study, the mean age of the patients at diagnosis time was 8.8 ± 11.6 year (at the range of one day to 76 years with median of 4 years). The percentage of females and males was 54.2 (n: 2014) and 43.8 (n: 1627), respectively. The chi-square test showed that there was significant difference in frequency of CHDs between females and males (P value < 0.0001). Ventricular septal defect (VSD) was found to be the most frequent of CHDs (27%). Patent ductus arteriosus (PDA) (16.8%), atrial septal defect (ASD) (15.8%), pulmonary stenosis (PS) (11%) and Tetralogy of Fallot (TOF) (8.9%) were more prevalent in CHDs after VSD. CONCLUSIONS The frequency of CHDs in female was more than male and VSD, PDA, ASD, PS, and TOF were most common in CHDs, respectively.
Collapse
Affiliation(s)
- Sara Amel-Shahbaz
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | | | | | - Abbas Andishmand
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Samane Moghimi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Negahdary
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | |
Collapse
|
12
|
Otaigbe BE, Tabansi PN. Congenital heart disease in the Niger Delta region of Nigeria: a four-year prospective echocardiographic analysis. Cardiovasc J Afr 2014; 25:265-8. [PMID: 25388927 PMCID: PMC4327180 DOI: 10.5830/cvja-2014-055] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 09/18/2014] [Indexed: 11/06/2022] Open
Abstract
Introduction Echocardiographic evaluation remains the gold standard for the diagnosis of structural cardiac disease. No previous prospective studies have been done on the prevalence of congenital heart disease (CHD) in the Niger Delta area. This study was done to determine the frequency and pattern of congenital heart disease, using echocardiography as a diagnostic tool. Methods All patients presenting to the Paediatric Cardiology clinics of two centres, the University of Port Harcourt Teaching Hospital and the Paediatric Care Hospital between April 2009 and March 2013, were recruited and all had echocardiography performed. Results Prevalence of CHD in this study was 14.4 per 1 000 children; 277 (83.4%) of the patients had acyanotic CHD and 55 (16.6%) had cyanotic CHD. Ventricular septal defect and tetralogy of Fallot were the commonest acyanotic and cyanotic heart defects, respectively Conclusion The high prevalence of CHD in this study is the highest in the country and Africa, and may be attributable to the increased oil spillage and gas flaring from petroleum exploitation in this region.
Collapse
Affiliation(s)
- B E Otaigbe
- Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt Rivers State, Nigeria.
| | - P N Tabansi
- Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt Rivers State, Nigeria
| |
Collapse
|
13
|
El-Hawary YM, El-Sayed B, Abd-Alhakem G, Ibrahim FM. Deciduous teeth structure changes in congenital heart disease: Ultrastructure and microanalysis. Interv Med Appl Sci 2014; 6:111-7. [PMID: 25243076 DOI: 10.1556/imas.6.2014.3.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 05/26/2014] [Accepted: 07/12/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Oral manifestations recorded for congenital heart disease (CHD) patients include teeth hypoplasia and high caries incidence. These observations suggested that the enamel and dentin of the teeth may be altered, increasing the risk for caries incidence. This study was designed to investigate the effect of CHD on the ultrastructure and composition of deciduous sound teeth. METHODS Thirty sound exfoliated human deciduous incisor teeth were selected for this study. They were divided into three groups, Group I (control) from healthy children (n = 6), Group II from acyanotic CHD children (n = 12) and Group III from cyanotic CHD children (n = 12). Each tooth was longitudinally sectioned, providing enough specimens for ultrastructure and chemical analysis using ESEM/EDAX. The results of ESEM/EDAX and dentin image analysis were statistically analyzed using one-way ANOVA test followed by Tukey's test. RESULTS Enamel of groups II and III showed increased dissolution and irregular orientation of enamel prisms. Orifices of dentinal tubules demonstrated widening and irregular outlines, also lateral branching increased markedly. Image analysis of dentin ESEM photomicrographs showed a highly significant increase in surface area of dentinal tubules. Decrease in calcium (Ca) and phosphorus (P) levels was statistically significant (P < 0.05). CONCLUSION CHDs affect the structure and chemical composition of deciduous teeth.
Collapse
|
14
|
Gorini F, Chiappa E, Gargani L, Picano E. Potential effects of environmental chemical contamination in congenital heart disease. Pediatr Cardiol 2014; 35:559-68. [PMID: 24452958 DOI: 10.1007/s00246-014-0870-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 01/07/2014] [Indexed: 12/18/2022]
Abstract
There is compelling evidence that prenatal exposures to environmental xenobiotics adversely affect human development and childhood. Among all birth defects, congenital heart disease (CHD) is the most prevalent of all congenital malformations and remains the leading cause of death. It has been estimated that in most cases the causes of heart defects remain unknown, while a growing number of studies have indicated the potential role of environmental agents as risk factors in CHD occurrence. In particular, maternal exposure to chemicals during the first trimester of pregnancy represents the most critical window of exposure for CHD. Specific classes of xenobiotics (e.g. organochlorine pesticides, organic solvents, air pollutants) have been identified as potential risk factors for CHD. Nonetheless, the knowledge gained is currently still incomplete as a consequence of the frequent heterogeneity of the methods applied and the difficulty in estimating the net effect of environmental pollution on the pregnant mother. The presence of multiple sources of pollution, both indoor and outdoor, together with individual lifestyle factors, may represent a further confounding element for association with the disease. A future new approach for research should probably focus on individual measurements of professional, domestic, and urban exposure to physical and chemical pollutants in order to accurately retrace the environmental exposure of parents of affected offspring during the pre-conceptional and pregnancy periods.
Collapse
Affiliation(s)
- Francesca Gorini
- Institute of Clinical Physiology, National Council of Research (CNR), via Moruzzi, 1, 56124, Pisa, Italy,
| | | | | | | |
Collapse
|
15
|
Tantchou Tchoumi JC, Butera G, Giamberti A, Ambassa JC, Sadeu JC. Occurrence and pattern of congenital heart diseases in a rural area of sub-Saharan Africa. Cardiovasc J Afr 2011; 22:63-6. [PMID: 21556446 PMCID: PMC3721952 DOI: 10.5830/cvja-2010-046] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 03/21/2010] [Indexed: 11/20/2022] Open
Abstract
Summary The extent of congenital heart disease in Cameroon remains largely unknown. The aim of this study was to determine the occurrence and pattern of congenital heart diseases in the Cardiac Centre of St Elizabeth Catholic General Hospital, situated in a rural area of Cameroon. Methods Between November 2002 and November 2008, a population of 2 123 patients with suspected cardiac pathologies were consulted at St Elizabeth Catholic General Hospital referral cardiac centre. Of these patients, 292 subjects were recruited for the study, based on detection of (1) precordial murmurs and/or cardiomegaly on chest X-ray examination, or (2) congenital heart diseases on transthoracic Doppler echocardiography examination. Results Congenital heart diseases and inorganic murmurs were found in 95.5 and 4.5% of the patients, respectively. Congenital heart diseases included tetralogy of Fallot (26.1%), isolated ventricular septal defect (38.8%), atrioventricular cushion defect (7.3%), isolated atrial septal defect (2.8%), arterial duct cases (12.4%), common arterial trunk (1.3%), isolated stenosis of the pulmonary artery (2.6%), coarctation of the aorta (1.1%), congenital mitral valve regurgitation (1.2%), atresia of the triscupid valve (1.6%), double-outlet right ventricle (2.1%), anomalous pulmonary venous return (1.5%) and left isomerism (1.2%). Conclusion Our data show that there is a high occurrence of congenital heart disease in this hospital in a rural zone of sub-Saharan Africa and that isolated ventricular septal defect is the predominant pathology. Post-surgical follow up remains very challenging as many parents cannot afford their children’s medical treatment or are generally not well educated.
Collapse
Affiliation(s)
- J C Tantchou Tchoumi
- Cardiac Centre, St Elizabeth Catholic General Hospital, Shisong, Kumbo, Cameroon.
| | | | | | | | | |
Collapse
|
16
|
Pattern and clinical aspects of congenital heart diseases and their management in Cameroon. ACTA ACUST UNITED AC 2011; 104:25-8. [PMID: 21287371 DOI: 10.1007/s13149-010-0091-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 08/04/2010] [Indexed: 10/18/2022]
Abstract
UNLABELLED The aim of the study was to investigate the occurrence, pattern and clinical aspects of congenital heart diseases and their management in Cameroon. In this multicentred retrospective study from January 2006 till November 2009, out of 51,636 consulting in three referral centres, 505 were recruited. All the patients presented with the following symptoms: cyanosis, clubbing, frequent respiratory tract infections, failure to thrive, growth retardation, precordial murmur and dyspnoea. Patients were sent for the screening of congenital heart disease. After the comprehensive Doppler echocardiography, the recruited patients were diagnosed with congenital (67.2%) and in few, acquired heart disease. Heart murmur, dyspnoea and growth retardation was the triad mostly encountered. The occurrence of congenital heart diseases in Cameroon is 9.87%. In Douala, isolated ventricular septal defect, interatrial septal defect and isolated pulmonary valve stenosis were more diagnosed than in Shisong (P <0.05) and Yaoundé (P <0.05). In Yaoundé, there were more cases of common arterial trunk, transposition of great arteries with ventricular septal defect and Ebstein disease than in Shisong (P <0.05) and Douala (P < 0.05). At Shisong, tetralogy of Fallot, arterial duct, coarctation of the aorta, congenital mitral valve regurgitation, atresia of the tricuspid valve, double outlet right ventricle, anomalous pulmonary venous return and left isomerism were more diagnosed than in Yaoundé (P <0.05) and in Douala (P <0.05). Thirty percent of the patients were operated abroad; 9% in the cardiac centre. CONCLUSION Our data show that congenital heart diseases are represented in Cameroon as in the literature; isolated ventricular septal defect is the predominant pathology.
Collapse
|
17
|
Bernier PL, Stefanescu A, Samoukovic G, Tchervenkov CI. The challenge of congenital heart disease worldwide: epidemiologic and demographic facts. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2010; 13:26-34. [PMID: 20307858 DOI: 10.1053/j.pcsu.2010.02.005] [Citation(s) in RCA: 254] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Congenital heart disease (CHD) afflicts a large number of children every year. The incidence of CHD is generally considered to be 8 per 1,000 live births. However, this estimate is perhaps inaccurate and does not take into consideration regional differences. A large review of the literature was performed to establish the true incidence of CHD and geographical variations. Data on the incidence of specific lesions and their geographical variation, as well as on mortality from CHD, was also reviewed. Taking into consideration the available data on incidence, mortality, and access to care, the global challenge that CHD represents was analyzed. Insight into how to confront this challenge is given.
Collapse
Affiliation(s)
- Pierre-Luc Bernier
- Division of Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | | |
Collapse
|
18
|
E. EE, A. ER, O. EK, M. NU. Services available to children of leprosy patients in leprosy settlements in Abia, and Oyo States of Nigeria. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2009. [DOI: 10.29333/ejgm/82670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
19
|
Tadmouri GO, Nair P, Obeid T, Al Ali MT, Al Khaja N, Hamamy HA. Consanguinity and reproductive health among Arabs. Reprod Health 2009; 6:17. [PMID: 19811666 PMCID: PMC2765422 DOI: 10.1186/1742-4755-6-17] [Citation(s) in RCA: 326] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Accepted: 10/08/2009] [Indexed: 12/11/2022] Open
Abstract
Consanguineous marriages have been practiced since the early existence of modern humans. Until now consanguinity is widely practiced in several global communities with variable rates depending on religion, culture, and geography. Arab populations have a long tradition of consanguinity due to socio-cultural factors. Many Arab countries display some of the highest rates of consanguineous marriages in the world, and specifically first cousin marriages which may reach 25-30% of all marriages. In some countries like Qatar, Yemen, and UAE, consanguinity rates are increasing in the current generation. Research among Arabs and worldwide has indicated that consanguinity could have an effect on some reproductive health parameters such as postnatal mortality and rates of congenital malformations. The association of consanguinity with other reproductive health parameters, such as fertility and fetal wastage, is controversial. The main impact of consanguinity, however, is an increase in the rate of homozygotes for autosomal recessive genetic disorders. Worldwide, known dominant disorders are more numerous than known recessive disorders. However, data on genetic disorders in Arab populations as extracted from the Catalogue of Transmission Genetics in Arabs (CTGA) database indicate a relative abundance of recessive disorders in the region that is clearly associated with the practice of consanguinity.
Collapse
|
20
|
Amro K. Pattern of congenital heart disease at Prince Hashim Hospital-Jordan. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2009. [DOI: 10.29333/ejgm/82662] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
21
|
Rahim F, Ebadi A, Saki G, Remazani A. Prevalence of Congenital Heart Disease in Iran: A Clinical Study. JOURNAL OF MEDICAL SCIENCES 2008. [DOI: 10.3923/jms.2008.547.552] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
22
|
Capozzi G, Caputo S, Pizzuti R, Martina L, Santoro M, Santoro G, Sarubbi B, Iacono C, D'Alto M, Bigazzi MC, Pacileo G, Merlino E, Caianiello G, Russo MG, Calabrò R. Congenital heart disease in live-born children: incidence, distribution, and yearly changes in the Campania Region. J Cardiovasc Med (Hagerstown) 2008; 9:368-74. [DOI: 10.2459/jcm.0b013e3282eee866] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
23
|
Fredriksen PM, Roislien J, Thaulow E. The estimated number of patients with adult congenital heart defects in Norway. Scand J Med Sci Sports 2007; 18:520-5. [DOI: 10.1111/j.1600-0838.2007.00734.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
24
|
Infective endocarditis in patients with congenitally malformed hearts: characterization of the syndrome in a developing country. Cardiol Young 2007; 17:623-30. [PMID: 17956654 DOI: 10.1017/s1047951107001345] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cardiac surgery for correction or palliation of congenital cardiac disease in infancy and childhood remains a privilege that is rarely accessible to two-thirds of the world's population. This imbalance has created a unique spectrum of illness in patients with underlying congenital cardiac disease and complicating infective endocarditis in developing countries, including Pakistan. In this study, we characterize endocarditis as seen in such patients presenting in Karachi. PATIENTS AND SETTINGS We reviewed retrospectively patients admitted to Aga Khan University with underlying congenitally malformed hearts and endocarditis between 1991 and 2004. RESULTS We identified 48 patients with endocarditis according to the modified Duke Criterions, with just over half the cases (54%) classified as definite endocarditis. Of the patients, 23 (49%) patients were more than 16 years old. Uncorrected left-to-right-shunts, tetralogy of Fallot, and congenital mitral valvar disease were the most common underlying defects. Patients with cyanotic defects, particularly of the complex type, were underrepresented (4%). Only 11 (22.9%) of the patients had a previous palliative or corrective surgery. In one-third of the patients (16), streptococcal species were identified as the microbiologic cause of endocarditis, and 22 (45.8%) had culture-negative endocarditis. In contrast, Staphylococcus aureus and enterococci caused endocarditis in only one patient each. There were no differences in mortality or complications between cyanotic and acyanotic congenital defects. Surgery was performed in nine (18.7%) patients with endocarditis, and of these, 13 (27.1%) died. CONCLUSIONS In contrast to the developed world, endocarditis in the developing countries, such as Pakistan, complicates uncorrected left-to-right shunts and tetralogy of Fallot, probably because patients with complex cyanotic defects fail to survive long after birth due to the lack of available surgery. Almost half of patients had culture-negative endocarditis, likely related to several factors.
Collapse
|
25
|
Alqurashi M, El Mouzan M, Al Herbish A, Al Salloum A, Al Omer A. Symptomatic congenital heart disease in the Saudi Children and Adolescents Project. Ann Saudi Med 2007; 27:442-4. [PMID: 18059120 PMCID: PMC6074170 DOI: 10.5144/0256-4947.2007.442] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Mansour Alqurashi
- Department of Pediatrics, Al-Yamamah Hospital, Riyadh, Saudi Arabia.
| | | | | | | | | |
Collapse
|
26
|
Bar-Dayan Y, Elishkevits K, Goldstein L, Goldberg A, Ohana N, Onn E, Levi Y, Bar-Dayan Y. The prevalence of common cardiovascular diseases among 17-year-old Israeli conscripts. Cardiology 2005; 104:6-9. [PMID: 15942176 DOI: 10.1159/000086046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2004] [Accepted: 10/29/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND There are only few reports on the prevalence of common cardiovascular disorders among adolescents. The previous studies focused on specific diseases, and screened relatively small samples. OBJECTIVE The aim of this study was to define the prevalence of different common cardiovascular disorders among 17-year-old Israeli conscripts. A comparison between the morbidity patterns of female and male adolescents was also performed. DESIGN All 17-years-old Israeli nationals are obliged by law to appear at the Israel Defense Forces Recruiting Office for medical examination except for orthodox religious and Arabic adolescents. Cardiology specialists evaluated and classified nominees with suspected cardiovascular disorders. RESULTS The most prevalent diagnoses were valvular heart disease (590/ 100,000), syncope (440/100,000), and mitral valve prolapse (340/100,000). The most prominent differences between female and male adolescents were noted in the prevalence of: congenital valvular heart disease, syncope, history of hypertension, supraventricular tachycardia with pre-excitation, myocarditis and pericarditis, and bradycardia and conduction disorders. CONCLUSIONS The most prevalent cardiac disorders among 17-year-old Israelis were congenital valvular heart disease, syncope and mitral valve prolapse. Some significant differences were noted between the morbidity patterns among male and female adolescents. The higher prevalence of congenital valvular heart disease compared to non-valvular heart disease is surprising. The prevalence of hypertension among Israeli adolescents in the last 15 years remained stable.
Collapse
Affiliation(s)
- Yaron Bar-Dayan
- Surgeon General Headquarters, Israeli Air Force and Israel Defense Forces Medical Corps, and Department of Health System Management, Faculty of Health Sciences, Ben Gurion University, Beer Sheba, Israel
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Bassili A, Mokhtar SA, Dabous NI, Zaher SR, Mokhtar MM, Zaki A. Risk factors for congenital heart diseases in Alexandria, Egypt. Eur J Epidemiol 2001; 16:805-14. [PMID: 11297222 DOI: 10.1023/a:1007601919164] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A matched case control study has been conducted in the children's hospitals in Alexandria, Egypt, during 2 years-period, aiming at investigating the risk factors for the occurrence of congenital heart diseases. Our results showed that the significant risk factors for developing any type of congenital heart disease and ventricular septal defects were: older paternal age at birth, positive consanguinity, positive family history, female sex hormones, irradiation, hazardous maternal occupation, diabetes mellitus and suburban or rural residence. However, some environmental/teratogenic factors were not implicated in the etiology of atrial septal defects or pulmonary stenosis. These findings strongly suggest that environmental factors vary according to the specific type of congenital heart disease. This study emphasizes on the need to instruct the public about the importance of pre-marital counseling and the deleterious effects of various teratogens in the environment.
Collapse
Affiliation(s)
- A Bassili
- Department of Medical Statistics, Medical Research Institute, Alexandria University, Egypt.
| | | | | | | | | | | |
Collapse
|