Clinical, echocardiographic, and therapeutic aspects of congenital heart diseases of children at Douala General Hospital: A cross-sectional study in sub-Saharan Africa.
INTRODUCTION
Cardiovascular diseases in pediatric pathologies have emerged in the recent years in sub-Saharan Africa (SSA), with congenital heart diseases (CHDs) being the most frequent. Unfortunately, their diagnosis is usually delayed, thereby increasing childhood morbidity and mortality.


OBJECTIVES
Describe the clinical, echocardiographic, and therapeutic aspects of CHDs of children at Douala General Hospital.


METHODS
We carried out a cross-sectional descriptive study over a 10-year period, from January 2006 to December 2015. Files and reports of cardiac ultrasounds of patients aged ≤ 15 years were reviewed.


RESULTS
We reviewed the medical records of 1616 children, of which 370 (22.9%) had CHD. The age range was 1 day to 15 years, with a mean of 26 months. Heart murmur was the most frequent clinical sign, seen in 72.3% of the cases. CHD with left-to-right shunt was seen in 61.8%, with ventricular septal defect being the most common (29.8% of all cases). The second most common CHDs were those due to obstruction (20.4%), mainly pulmonary stenosis (19.6% of all cases). Cyanogenic CHDs accounted for 17.8% of cases, dominated by tetralogy of Fallot (7.4% of all cases). Indications for surgical treatment was found in 171 (46.2%) patients, but due to financial constraints, only 48 (28.1%) patients were operated. Among those who underwent surgery, 66.7% were operated abroad, and Humanitarian organizations financed the surgical management of 58.3% of those operated.


CONCLUSIONS
CHDs are seen in one out of five children seen in the pediatric cardiology unit of our Hospital for suspected heart disease. Most cases are diagnosed late in life as toddlers. The rate of surgical correction remains low due to financial constraints, with most cases operated abroad with the assistance of Humanitarian organizations.
['Kamdem|Félicité|F|', 'Kedy Koum|Danielle|D|', 'Hamadou|Ba|B|', 'Yemdji|Mélanie|M|', 'Luma|Henry|H|', 'Doualla|Marie Solange|MS|', 'Noukeu|Diomède|D|', 'Barla|Esther|E|', 'Akazong|Christophe|C|', 'Dzudie|Anastase|A|', 'Ngote|Henry|H|', 'Monkam|Yves|Y|', 'Mouliom|Sidiki|S|', 'Kingue|Samuel|S|']
D000293:Adolescent D002163:Cameroon D006348:Cardiac Surgical Procedures D002648:Child D002675:Child, Preschool D003430:Cross-Sectional Studies D019468:Disease Management D004452:Echocardiography D005260:Female D005500:Follow-Up Studies D005544:Forecasting D006330:Heart Defects, Congenital D006769:Hospitals, General D006801:Humans D007223:Infant D007231:Infant, Newborn D008297:Male D009017:Morbidity D012959:Socioeconomic Factors D015996:Survival Rate
congenital heart disease children Douala General Hospital sub-Saharan Africa