CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 2, March/April 2011
AFRICA
63
Cardiovascular Topics
Occurrence and pattern of congenital heart diseases in a
rural area of sub-Saharan Africa
JC TANTCHOU TCHOUMI, G BUTERA, A GIAMBERTI, JC AMBASSA, JC SADEU
Summary
The extent of congenital heart disease in Cameroon remains
largely unknown. The aim of this study was to determine the
occurrence and pattern of congenital heart diseases in the
Cardiac Centre of St Elizabeth Catholic General Hospital,
situated in a rural area of Cameroon.
Methods:
Between November 2002 and November 2008, a
population of 2 123 patients with suspected cardiac patholo-
gies were consulted at St Elizabeth Catholic General Hospital
referral cardiac centre. Of these patients, 292 subjects were
recruited for the study, based on detection of (1) precordial
murmurs and/or cardiomegaly on chest X-ray examination,
or (2) congenital heart diseases on transthoracic Doppler
echocardiography examination.
Results:
Congenital heart diseases and inorganic murmurs
were found in 95.5 and 4.5% of the patients, respective-
ly. Congenital heart diseases included tetralogy of Fallot
(26.1%), isolated ventricular septal defect (38.8%), atrioven-
tricular cushion defect (7.3%), isolated atrial septal defect
(2.8%), arterial duct cases (12.4%), common arterial trunk
(1.3%), isolated stenosis of the pulmonary artery (2.6%),
coarctation of the aorta (1.1%), congenital mitral valve
regurgitation (1.2%), atresia of the triscupid valve (1.6%),
double-outlet right ventricle (2.1%), anomalous pulmonary
venous return (1.5%) and left isomerism (1.2%).
Conclusion:
Our data show that there is a high occurrence
of congenital heart disease in this hospital in a rural zone
of sub-Saharan Africa and that isolated ventricular septal
defect is the predominant pathology. Post-surgical follow
up remains very challenging as many parents cannot afford
their children’s medical treatment or are generally not well
educated.
Keywords:
congenital heart diseases, sub-Saharan Africa,
ventricular septal defect, Cameroon
Submitted 13/11/09, accepted 21/3/10
Cardiovasc J Afr
2010;
21
: 63–66
DOI: CVJ-21.033
Congenital heart disease is defined as an abnormality in the
cardio-circulatory structure or function, which is either present
at birth or appears much later in life. The prevalence and pattern
of this group of disorders varies both within and between
regions and countries.
1,2
However, the extent of its occurrence in
Cameroon is largely unknown.
3
In the majority of developing nations, and especially in most
countries in the African continent, only a small and insignifi-
cant portion of the population can afford the cost of diagnosis,
medical treatment and/or surgical correction of congenital heart
diseases. The situation is even worse for those living in rural
areas where access to basic healthcare is already a serious issue.
Despite their wealth in natural resources, rural areas in develop-
ing countries are usually the poorest regions in terms of financial
resources. These regions depend entirely on the availability of
public health funding to finance and support their healthcare.
Most of the time these funds do not reach them or are simply
not provided.
The Shisong referral cardiac centre is specialised in both adult
and paediatric cardiology and is part of Shisong’s St Elizabeth
Catholic General Hospital, located in a rural area of the north-
west province of Cameroon. This geographic location strategi-
cally complies with the principal mission of this hospital, which
is to provide healthcare support to economically deprived rural
areas of the country.
Since November 2002, when the cardiac centre became
operational, a significant number of patients have presented at
the hospital and been treated for various pathologies.
4
Obviously,
treatment and prevention of malaria and HIV, and vaccination
programmes are top of the list of priorities for public health in
Cameroon. However, in our personal experience to date, we
know that in Cameroon there are a significant number of patients
with diagnosed or undiagnosed congenital heart diseases who are
helpless because of associated expensive treatment.
The only scientifically based approach to draw public health
attention to the seriousness of the problem is to provide
evidence-based data that support our observations. Currently,
there are no epidemiological data available on the prevalence
and management of congenital heart diseases in Cameroon,
and only a limited number of published studies on rural areas
Cardiac Centre, St Elizabeth Catholic General Hospital,
Shisong, Kumbo, Cameroon
JC TANTCHOU TCHOUMI, MD,
JC AMBASSA, MD
Paediatric Cardiac Surgery Department, Policlinico San
Donato, Milan, Italy
G BUTERA, MD
A GIAMBERTI, MD
Department of Obstetrics and Gynaecology, Reproductive
Biology Divison, McMaster University, Hamilton, Ontario,
Canada
JC SADEU, MD
