In a retrospective study of 1224 transthoracic
echocardiograms performed between January 2011 and December 2013, we evaluated
the spectrum of congenital heart disease
(CHD) diagnosed at a tertiary referral centre in Maiduguri,
north-eastern Nigeria. Diagnosis of CHD was made in 88 (8.3%) subjects,
comprising 23 (26.1%) adults and 65 (73.9%) aged less than 18 years. Forty six
(52.3%) of those with CHD were females, while 42 (47.7%) were males. The
frequencies of the CHD in decreasing order were: ventricular septal defect 23
(26.1%), tetralogy of Fallot (TOF) 14(15.9%) and atrial septal defect (ASD) and
atrioventricular septal defect (AVSD) were 11 (12.5%) each. One of the patients
with AVSD had Ellis Van Creveldt syndrome. Six (6.8%) cases of patent ductus
arteriosus (PDA) were diagnosed in those younger than 18 years, while all the 5
(5.7%) cases of Ebstein’s anomaly were diagnosed in adults. There were 6(6.8%) cases of Eisenmenger syndrome involving three
cases of AVSD, one case of ASD and two cases of Ebstein’s anomaly. Timely
definitive cares for these patients are still lacking in Nigeria and many areas
of sub-Saharan Africa. We recommend sensitization of all relevant clinicians to
actively look for congenital heart defects. Pulse oximetry and postnatal echocardiographic
new-born screening which were previously validated should be implemented at
secondary and tertiary levels, and efforts should be made towards providing the needed care for
patients with CHD.
References
[1]
Moran, A., Forouzanfar, M., Samson, U., Chugh, S., Feigin, V. and Mensah, G. (2013) The Epidemiology of Cardiovascular Diseases in Sub-Saharan Africa: The Global Burden of Diseases, Injuries and Risk Factors 2010 Study. Progress in Cardiovascular Diseases, 56, 234-239. https://doi.org/10.1016/j.pcad.2013.09.019
[2]
Ogah, O.S., Adegbite, G.D., Akinyemi, R.O., Adesina, J.O., Alabi, A.A., Udofia, O.I., et al. (2008) Spectrum of Heart Diseases in a New Cardiac Service in Nigeria: An Echocardiographic Study of 1441 Subjects in Abeokuta. BMC Research Notes, 1, 98. https://doi.org/10.1186/1756-0500-1-98
[3]
Jing, A.M., Noubiap, J.J., Kamdem, P., WawoYonta, E., Temfack, E., KouamKouam, C., et al. (2013) The Spectrum of Cardiac Disease in the West Region of Cameroon: A Hospital-Based Cross-Sectional Study. International Archives of Medicine, 6, 44. https://doi.org/10.1186/1755-7682-6-44
[4]
Sadoh, W.E., Uzodimma, C.C. and Daniels, Q. (2013) Congenital Heart Disease in Nigerian Children: A Multicentre Echocardiographic Study. World Journal for Pediatric and Congenital Heart Surgery, 4, 172-176. https://doi.org/10.1177/2150135112474026
[5]
Sani, M.U., Mukhtar-Yola, M. and Karaye, K.M. (2007) Spectrum of Congenital Heart Disease in a Tropical Environment: An Echocardiographic Study. Journal of the National Medical Association, 99, 665-669.
[6]
Thomas, M.O., Olusoji, O. and Awolola, N. (2013) Spectrum of Congenital Heart Disease in an African Population: A Necropsy Study. World Journal of Cardiovascular Diseases, 3, 34-39. https://doi.org/10.4236/wjcd.2013.31008
[7]
Hoffman, J.I.E. (2013) The Global Burden of Congenital Heart Disease. Cardiovascular Journal of Africa, 24, 141-145. https://doi.org/10.5830/CVJA-2013-028
[8]
Perloff, J.K. and Warnes, C. (2001) Congenital Heart Disease in Adults: A New Cardiovascular Specialty. Circulation, 84, 1881-1890 https://doi.org/10.1161/01.CIR.84.5.1881.
[9]
Wren, C. and O’Sullivan, J.J. (2001) Survival with Congenital Heart Disease and Need for Follow Up in Adult Life. Heart, 85, 438-443 https://doi.org/10.1136/heart.85.4.438
[10]
Houston, A., Hillis, S., Lilley, S., Richens, T. and Swan, L. (1998) Echocardiography in Adult Congenital Heart Disease. Heart, 80, S12-S26 https://doi.org/10.1136/hrt.80.2008.12s
[11]
Alonso-Gonzalez, R. and Swan, L. (2013) Non-Invasive Imaging in Congenital Heart Disease. Heart, 10, 592-598.
[12]
Ibadin, M.O., Sadoh, W.E. and Osarogiagbon, W. (2005) Congenital Heart Disease at the University of Benin Teaching Hospital. Nigerian Journal of Paediatrics, 32, 29-32.
[13]
Lang, R.M., Bierig, M., Devereux, R.B., Flachskampf, F.A., Foster, E., Pellikka, P.A., et al. (2005) Recommendations for Chamber Quantification: A Report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18, 1440-1463. https://doi.org/10.1016/j.echo.2005.10.005
[14]
Anderson, R.H., Becker, A.E., Freedom, R.M., Macartney, F.J., Quero-Jimenez, M., Shinebourne, E.A., et al. (1984) Sequential Segmental Analysis of Congenital Heart Disease. Pediatric Cardiology, 5, 281-287.
[15]
Lopez, L., Colan, S.D., Frommelt, P.C., et al. (2010) Recommedations for Quantification Methods during Performance of a Pediatric Echocardiogram: A Report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. Journal of the American Society of Echocardiography, 23, 465-495. https://doi.org/10.1016/j.echo.2010.03.019
[16]
Grabitz, R.G., Joffres, M.R. and Collins-Nakai, R.L. (1988) Congenital Heart Disese: Incidence in the First Year of Life. The Alberta Heritage Pediatric Cardiology Program. Journal of the American Society of Echocardiography, 128, 381-388.
[17]
Nembhard, W.N., Wang, T., Loscalzo, M. and Salemi, J.L. (2010) Variation in the Prevalence of Congenital Heart Defects by Maternal Race/Ethnicity and Infant Sex. Journal of Pediatrics, 156, 259-264. https://doi.org/10.1016/j.jpeds.2009.07.058
[18]
Gupta, B. and Antia, A.U. (1967) Incidence of Congenital Heart Disease in Nigerian Children. British Heart Journal, 29, 906-909.
[19]
Tantchou Tchoumi, J.C., Ambassa, J.C., Kingue, S., et al. (2011) Occurrence, Aetiology and Challenges in the Management of Congestive Heart Failure in Sub-Saharan Africa: Experience of the Cardiac Centre in Shisong, Cameroon. The Pan African Medical Journal, 8, 11.
[20]
Marijon, E., Tivane, A., Voicu, S., et al. (2006) Prevalence of Congenital Heart Disease in Schoolchildren of Sub-Saharan Africa, Mozambique. International Journal of Cardiology, 113, 440-441. https://doi.org/10.1016/j.ijcard.2006.06.049
[21]
Manuel, V., Morais, H., Manuel, A., David, B. and Gamboa, S. (2014) Ventricular Septal Defect in Children and Adolescents in Angola: Experience of a Tertiary Centre. Revista Portuguesa de Cardiologia, 33, 637-640. https://doi.org/10.1016/j.repc.2014.03.012
[22]
Rahim, F., Ebadi, A., Saki, G. and Remazani, A. (2008) Prevalence of Congenital Heart Disease in Iran: A Clinical Study. Journal of Medical Science, 8, 547-552.
[23]
Warnes, C.A., Williams, R.G., Bashore, T.M., et al. (2008) ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease. Circulation, 118, e714-e837. https://doi.org/10.1161/CIRCULATIONAHA.108.190690
[24]
Sani, U.M., Jiya, N.M., Ahmed, H. and Waziri, U.M. (2015) Profile and Outcome of Congenital Heart Diseases in Children: A Preliminary Experience from a Tertiary Centre in Sokoto, North Western, Nigeria. Nigerian Postgraduate Medical Journal, 22, 1-8.
[25]
Minnette, M.S. and Sahn, D.A. (2006) Ventricular Septal Defects. Circulation, 114, 2190-2197.
Nikyar, B., Sedehi, M., Mirfazelli, A., Qurbani, M. and Golalipur, M.J. (2011) Prevalence and Pattern of Congenital Heart Disease among Neonates in Gorgan, Northern Iran (2007-2008). Iranian Journal of Pediatrics, 21, 307-312.
Kaemmerer, H., Mebus, S., Sculze-Neick, I., et al. (2010) The Adult Patient with Eisenmengersyndrome: A Medical Update after Dana Point: Part I: Epidemiology, Clinical Aspects and Diagnostic Options. Current Cardiology Reviews, 6, 343-355.
[30]
Badesch, D.B., Champion, H.C., Sanchez, M.A., et al. (2009) Diagnosis and Assessment of Pulmonary Arterial hypertension. Journal of the American College of Cardiology, 54, S55-S66.
[31]
Duffels, M.G., Engelfriet, P.M., Berger, R.M., et al. (2007) Pulmonary Arterial Hypertension in Congenital Heart Disease: An Epidemiologic Perspective from a Dutch registry. International Journal of Cardiology, 120, 198-204. https://doi.org/10.1016/j.ijcard.2006.09.017
[32]
Baujat, G. and Merrrer, L. (2007) Ellis-Van Creveld Syndrome. Orphanet Journal of Rare Diseases, 2, 27. http://www.OJRD.com/content/2/1/27
[33]
Thangaratinam, S., Brown, K., Zamora, J., et al. (2012) Pulse Oximetry Screening for Critical Congenital Heart Defects in Asymptomatic Newborn Babies: A Systematic Review and Meta-Analysis. Lancet, 379, 2459-2464. https://doi.org/10.1016/S0140-6736(12)60107-X
[34]
Sadoh, W.E.U., Zodinma, C.C. and Daniels, Q. (2013) Congenital Heart Disease in Nigerian Children: A Multicenter Echocardiographic Study. World Journal for Pediatric and Congenital Heart Surgery, 4, 172-176. https://doi.org/10.1177/2150135112474026
