CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 5, May 2013
AFRICA
13
ing symptom in Africa. NCCM is a rare condition and can present
with adverse symptoms. A high index of suspicion is required
to diagnose it. Medical treatment with amiodarone and antico-
agulation is effective and safe to manage it. ICDs remain the ideal
definitive therapy to improve the otherwise adverse prognosis of
the condition.
THE THIKA DIABETES STUDY: DIABETES IN NEWLY
ADMITTED PATIENTS AT A REFERRAL COUNTY HOSPI-
TAL IN KENYA
Kamotho C*
International Clinic, Nairobi, Kenya
Introduction:
Diabetes is estimated to increase by 161% by the
year 2030 in sub-Saharan Africa as compared with 54% in the
established market economies of the West. INTERHEART Africa
showed that the odds ratio (OR) of diabetes leading to a new
myocardial infarction in Africans was 3.55 (2.53–4.99), higher
than in the overall INTERHEART Study, 3.07 (2.84–3.33). A study
of black Africans with angiographically evident coronary artery
disease showed that diabetes was significantly more prevalent in
such individuals (38.5%) than in those with normal coronary arter-
ies (12%,
p
=0.0002).
Subjects and methods:
This prospective, descriptive study of
disease prevalence, which was preceded by a pilot study, involved
blood sugar measurements of serially admitted patients at Thika
Level 5 Hospital, Kenya, in January 2010. A total of 145 patients
were studied and results of 141 were analysed. Random blood sugar
measurements were done for patients on admission followed by
fasting blood sugar (FBS) assessments.
Results:
Of the 141 patients, a total of 46 (32.6%) patients had FBS
of 7.0 mmol/l and above, hence had diabetes mellitus; 13 (9.2%)
were known diabetics and 33 (23.4%) of the 141 were newly diag-
nosed diabetics. Nineteen (13.5%) patients had impaired fasting
glucose, defined by FBS from 6.1 to 6.9 mmol/l. Only one of these
19 patients was a known diabetic, all the others being newly diag-
nosed with the abnormality. Therefore an important 65 (46%) of all
the patients in the study had abnormal glucose metabolism, and a
total of 51 (36%) were newly diagnosed with hyperglycaemia.
Interpretation:
The prevalence of diabetes mellitus (and impaired
fasting glucose) in newly diagnosed patients admitted at this
county hospital in Kenya was found to be considerably high. More
concerning still was the very high prevalence of newly diagnosed
diabetics. It is recommended therefore that aggressive screening be
done at the admission points of such hospitals to pre-empt cardio-
vascular complications.
SIGNIFICANCE OF RATE PRESSURE PRODUCT IN
HEART FAILURE PATIENTS
Karaye KM*, Akintunde AA
Departments of Medicine, Bayero University, Aminu Kano Teaching
Hospital, Kano, and Ladoke Akintola University of Technology
Teaching Hospital, Ogbomoso, Nigeria     
Introduction:
The rate pressure product (RPP) is a strong deter-
minant of myocardial oxygen consumption, and relates strongly
to important indices for morbidity and cardiovascular mortality.
Its significance in black African subjects with heart failure (HF)
has however not been well described. This study therefore aimed
to assess the significance of RPP among admitted HF patients in 2
Nigerian centres.
Subjects and methods:
Admitted HF patients in the 2 centres
were serially recruited after satisfying all inclusion criteria. RPP
was calculated by multiplying heart rate by systolic blood pressure
at admission. Subjects were classified into 2 groups based on RPP
<10 000 (group 1) or above (group 2), which is a cut-off value
above which there is increased risk of myocardial ischaemia.
Results:
A total of 100 subjects (53% female) were recruited from
the 2 centres with a mean age of 47.3 ± 19.5 years; 35% of the
subjects were in group 1 while 65% were in group 2. N-terminal
B-type natriuretic peptide (NT-BNP), serially measured in only 37
subjects (12 in group 1; 25 in group 2), was significantly higher
in group 1 as compared with group 2 (
p
=0.016). Group 1 also
had lower intraventricular septal thickness (IVST) (
p
=0.007) as
compared with group 2 subjects. RPP correlated strongly with
IVST (r=+0.510,
p
<0.001), left ventricular posterior wall thickness
(LVPWT) (r=+0.399,
p
<0.001) and LV end-diastolic dimension
(LVEDD) (r=-0.202,
p
=0.045). RPP >10 000 was strongly associat-
ed with IVST (95% confidence interval (CI): 1.061–1.528,
p
=0.009)
and NT-BNP (CI 0.999–1.000,
p
=0.026). There was however no
significant relationship (
p
>0.05) between RPP and in-hospital
mortality, severity of dyspnoea, gender, age, body weight, LV ejec-
tion fraction or presence of atrial fibrillation/flutter.
Interpretation:
This study confirms the close relationship that
exists between a determinant of myocardial oxygen consump-
tion (RPP), and indices for LV wall tension (IVST, LVEDD and
NT-BNP), in black Africans with HF.
CARDIOPATHIES DE L’ENFANT AU CENTRE HOSPI-
TALIER UNIVERSITAIRE PEDIATRIQUE CHARLES DE
GAULLE (CHUP CDG) DE OUAGADOUGOU: ASPECTS
EPIDEMIOLOGIQUES, CLINIQUES, THERAPEUTIQUES
ET EVOLUTIFS
HEART DISEASES IN THE INFANT AT THE CHARLES DE
GAULLE PAEDIATRIC UNIVERSITY HOSPITAL (CHUP
CDG) OF OUAGADOUGOU: EPIDEMIOLOGY, CLINICAL
AND THERAPEUTIC OUTCOMES
Kinda G*, Ouédraogo S, Yugbaré A, Kaboré L, Dao H, Cissé F,
Koueta D, Yé P, Zabsonré L, Lougué S
Service de Pédiatrie Médicale du CHUP-CDG de Ouagadougou,
Burkina Faso
Introduction:
Faire l’état des lieux des cardiopathies de l’enfant
au CHUP CDG de Ouagadougou en vue d’une organisation du
système de diagnostic et de prise en charge.
Subjects and methods:
Il s’agit d’une étude prospective, trans-
versale à visée descriptive concernant des enfants souffrant de
cardiopathie vus en hospitalisation ou en consultation au CHU du
1er Janvier 2012 au 31 Décembre 2012.
Results:
Sur un total de 149 enfants porteurs de cardiopathies (soit
une fréquence de 1.16%), nous avons observé 69.8% d’enfants
porteurs de cardiopathies congénitales, 27.5% de cardiopathies
acquises et 2.7% de formes associées. Pour les cardiopathies
congénitales (148 cas observées chez 108 enfants), la CIV a été
prédominante (31.76 %) suivie de la CIA (20.27%). La T4F a
été observée dans 5.42% des cas. Le sexe masculin a représenté
48.7% des cas et le sexe féminin 51.3%. L’âge moyen a été de
3.65 ans avec des extrêmes de 2 jours à 15 ans. Pour les cardiopa-
thies acquises (41 cas), les lésions valvulaires rhumatismales ont
représenté 63.4% des cas suivies de la péricardite non rhumatismale
(21.9% des cas). La détresse respiratoire a constitué le premier
motif de consultation (61.7% des enfants), le souffle cardiaque et la
détresse respiratoire étaient présents respectivement dans 64.4% et
51% des enfants. Le mongolisme a été la malformation associée la
plus fréquemment rencontrée (11 cas). Nous avons mis 111 malades
sous traitement médical, les 38 autres étaient asymptomatiques.
Nous avons observé deux cas de fermeture spontanée (1 CIV et 1
CIA). L’indication chirurgicale a été posée dans 79 cas et un seul
malade a été opéré. Nous avons noté 13 cas de décès (8.8%) dont 8
cas de cardiopathies congénitales et 5 cas de cardiopathies acquises,
1 abcès du cerveau, 3 cas de syndrome d’Eisenmenger, 1 chorée et
1 endocardite d’Osler ont constitué nos lots de complications.
Interpretation:
Pour une meilleure prise en charge des cardiopa-
thies de l’enfant au CHUP CDG, il est urgent d’y mettre en place
une organisation performante impliquant les organismes d’aides à
l’enfance.
1...,5,6,7,8,9,10,11,12,13,14 16,17,18,19,20,21,22,23,24,25,...40