Epidemiological Investigation of Rheumatic Heart Disease in the Emergency Department in Dakar: A Descriptive Analysis
Aliou Thiongane *
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Sénégal.
Abou Ba
Service de Pédiatrie Hôpital Dalal Jamm, Dakar, Sénégal.
Fatou Ly
Service de Pédiatrie Hôpital Pikine, Dakar, Sénégal.
Aliou A. Ndongo
Service de Pédiatrie Hôpital Abass Ndao, Dakar, Sénégal.
Djibril Boiro
Service de Pédiatrie Hôpital Abass Ndao, Dakar, Sénégal.
Younoussa Kéita
Service de Pédiatrie Hôpital Abass Ndao, Dakar, Sénégal.
Idrissa Basse
Centre Hospitalier National d’Enfants de Diamniadio, Dakar, Sénégal.
Babacar Niang
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Sénégal.
Indou Dême Ly
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Sénégal.
Yaye Joor Dieng
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Sénégal.
Djenaba Fafa Cissé
Service de Pédiatrie Hôpital Pikine, Dakar, Sénégal.
Ndiogou Seck
Service de Pédiatrie Hôpital Régional, Saint Louis, Sénégal.
Lamine Thiam
Service de Pédiatrie Hôpital de La Paix de Ziguinchor, Sénégal.
Amadou Lamine Fall
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Sénégal.
Papa Moctar Faye
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Sénégal.
Assane Sylla
Service de Pédiatrie Hôpital Abass Ndao, Dakar, Sénégal.
Ousmane Ndiaye
Centre Hospitalier National d’Enfants Albert Royer, Dakar, Sénégal.
*Author to whom correspondence should be addressed.
Abstract
Background: Rheumatic Heart Disease (RHD), also known as "Bouillaud's disease", is a post-streptococcal non-suppurative inflammatory disease complicating an upper airway infection with group A β-hemolytic streptococcus. Although RHD has almost disappeared in developed countries, it is still a major public health problem in low- and middle-income countries, as it remains the most frequent cause of cardiovascular mortality and morbidity in children. The objective was to describe the epidemiological and evolutionary aspects of rheumatic heart disease admitted to the emergency room of the Albert Royer National Children's Hospital in Dakar.
Methods: We conducted a retrospective, descriptive study over a 12-month period (January 1 to December 31, 2021) of children aged 3 to 18 years hospitalized for rheumatic heart disease in the emergency department during the study period.
Results: The prevalence was 3.73% (37/993) with a mean age of 11.35 +/- 3 years and a majority between 10 and 15 years. Males predominated - sex ratio 1.3. The majority came from disadvantaged areas (91.9%) with low incomes for the most part (83.8%). The reasons for consultation were dominated by dyspnea (86.5%), fever (75.7%) and poly-arthralgia (35.1%). General and physical signs were tachycardia (86.5%), orthopnea (24.3%), hypoxia (40.5%), congestive heart failure (83.7%). Cardiac involvement was dominated by mitral and aortic polyvalvular disease in more than half (57%). Management included diuretics (97.3%), oxygen therapy (90%), corticosteroids (31%) and antibiotics (81%). Three cases of death were noted.
Conclusion: RHD is still frequent in our countries with an often poor prognosis due to delayed management. Prevention policies are necessary to eradicate this scourge.
Keywords: Rheumatic heart disease, polyvalvular disease, children, death