Key result
In a Kenyan pediatric population, congestive heart failure was most commonly caused by infections (22.8%), anemia (17.1%), rheumatic heart disease (14.6%), and congenital heart disease (13.3%), with an overall mortality rate of 7.6%.
Observational (n=158)
No
In a Kenyan pediatric cohort, heart failure is primarily driven by preventable or treatable conditions like infection, anemia, and rheumatic heart disease, contrasting with patterns in developed nations.
Highlights preventable HF causes in Kenyan children; hypothesis-generating for targeted prevention in similar low-resource settings.
BACKGROUND: Heart failure in children is a common cause of morbidity and mortality, with high socio-economic burden. Its pattern varies between countries but reports from Africa are few. The data are important to inform management and prevention strategies. OBJECTIVE: To describe the pattern of congestive heart failure in a Kenyan paediatric population. METHODS: This was a retrospective study done at Kenyatta National Hospital, Nairobi Kenya. Records of patients aged 12 years and younger admitted with a diagnosis of heart failure between January 2006 and December 2010 were examined for mode of diagnosis, age, gender, cause, treatment and outcome. Data were analysed using the Statistical Programme for Social Scientists version 16.0 for windows, and presented in tables, bar and pie charts. RESULTS: One hundred and fifty-eight cases (91 male, 67 female) patients' records were analysed. The mean age was 4.7 years, with a peak at 1-3 years. The male: female ratio was 1.4:1. All the cases were in New York Heart Association (NYHA) class II-IV. Evaluation of infants was based on the classification proposed by Ross et al. (1992). Diagnosis was made based on symptoms and signs combined with echocardiography (echo) and electrocardiography (ECG) (38%); echo alone (12.7%); ECG, echo and chest X-ray (CXR) (11.4%); and ECG alone (10.8%). The underlying cause was established on the basis of symptoms, signs, blood tests, CXR, echo and ECG results. Common causes were infection (22.8%), anaemia (17.1%), rheumatic heart disease (14.6%), congenital heart disease (13.3%), cardiomyopathy (7.6%), tuberculosis and human immunodeficiency virus (6.9% each); 77.9% of patients recovered, 13.9% after successful surgery, and 7.6% died. CONCLUSION: Congestive heart failure is not uncommon in the Kenyan paediatric population. It occurs mainly before five years of age, and affects boys more than girls. The majority are due to infection, anaemia, and rheumatic and congenital heart diseases. This differs from those in developed countries, where congenital heart disease and cardiomyopathy predominate. The majority of children usually recover. Prudent control of infection and correction of anaemia are recommended.
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Ogeng’o et al. (2013) conducted an observational in Congestive heart failure (n=158). Congestive heart failure was evaluated on Underlying causes of congestive heart failure. In a Kenyan pediatric population, congestive heart failure was most commonly caused by infections (22.8%), anemia (17.1%), rheumatic heart disease (14.6%), and congenital heart disease (13.3%), with an overall mortality rate of 7.6%.
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