CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 2, March/April 2011
66
AFRICA
but it is important to highlight the multi-tribal orientation of the
hospital as Cameroon is a country where the way someone is
treated could be determined by his/her tribal origin, depending if
that tribe is well represented or not in society.
We also found that congenital heart diseases were predomi-
nant in the Banso and Bamileke people. However, this could
be due to the fact that the majority of patients came from these
regions, which are closest to the hospital. Bamileke are known
to marry close relatives and therefore we could hypothesise that
genetic background could be linked to the predominance of
congenital heart diseases found in this tribe. However, unless
scientifically proven, this must remain an assumption.
Since there are only a few cardiac centres in the country,
and more importantly because patients cannot afford the cost of
treatment, pre- and post-surgical follow up is very challenging.
There is a need to establish programmes to better inform patients
about their disease and the importance of proper follow up. More
than 60% of children have a very poor academic background
and almost the same percentage of rural parents do not have a
secondary school education.
Long-term post-surgical death rate is estimated at 0.7% and
the main cause of death is thought to be malignant arrhythmias
occurring after correction of the congenital heart disease. In
developed countries, particularly Europe and America, diagnosis
and treatment of cardiac pathologies are readily affordable by
most citizens through coverage by insurance plans. In the major-
ity of developing nations, especially countries on the African
continent, this is not yet the case.
Thanks to the positive partnership between St Elizabeth
Catholic General Hospital, Policlinico San Donato in Milan,
Tertiary Sisters of St Francis, Associazione Bambini Cardiopatici
nel Mondo and Cuore Fratello, some hope is offered to patients
and their families. The initiative of St Elizabeth Catholic General
Hospital in supporting early detection, diagnosis, treatment
and patient follow up is encouraging; however, public health
involvement and better funding are required to cover the expens-
es so that all patients are afforded the opportunity to receive
proper treatment in a timely manner.
Conclusion
The data showed that a wide range of congenital heart diseases
were represented in the cardiac centre of St Elizabeth Catholic
General Hospital, Shisong, situated in a sub-Saharan rural area
of Africa, and that isolated ventricular septal defect was the
most prevalent pathology. However, despite successful cardiac
surgery and treatment, patient follow up remained a significant
challenge.
The authors thank the St Elizabeth Catholic General Hospital, Policlinico
San Donato in Milan, Tertiary Sisters of St Francis, Associazione Bambini
Cardiopatici nel Mondo and Cuore Fratello for providing the necessary finan-
cial support for patients’ sanitary evacuation and medical treatment. Their
partnership in the construction of the first paediatric cardiac surgery centre
in the central and western region of Africa is also very much appreciated.
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