Cardiovascular Journal of Africa: Vol 26 No 5 (September/October 2015)

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CARDIOVASCULAR JOURNAL OF AFRICA • Vol 26, No 5, October/November 2015 32 AFRICA
Introduction: The high prevalence of rheumatic heart disease
(RHD) in low-income compared to high-income settings is
reflective of the impact of socio-economic factors on disease
aetiology and prognosis. The intersection of these biosocio-
economic factors influences health-seeking behaviour for those
with throat infections, and adherence to secondary prophylaxis
for acute rheumatic fever (ARF) patients. The dearth of infor-
mation around the experiences of RHD patients in endemic
communities curtails the formulation and implementation of
effective programmes that seek to prevent the occurrence and
control of RHD. Our aim is to identify factors that influence
health-seeking behaviour at different stages of disease and
adherence to secondary prophylaxis utilising a rapid ethno-
graphic approach.
Methods and Results: We propose to use a mixed-methods
qualitative research design to explore patients’ experiences
from primary infection to overt RHD. The population will be
composed of three patient groups: patients with throat infec-
tion, those with ARF and those with RHD. We will employ
non-probability sampling techniques to select respondents.
We anticipate using patient interviews, focus groups and novel
techniques, such as photo elicitation and digital storytelling.
Findings will be triangulated to explore relationships, note
contractions and identify common barriers.
Conclusion: This protocol will determine the factors that influ-
ence health-seeking behaviour and adherence to secondary
prophylaxis for patients with sore throat, ARF and RHD across
diverse communities. In addition, it should identify opportuni-
ties for interventions and note challenges associated with the
formulation and implementation of such interventions. A final
possible benefit would be the application to the evaluation of
already existing or newly formulated RHD control programmes.
ROLE OF ECHOCARDIOGRAPHY AND CARDIAC CT IN
THE DIAGNOSIS OF CONSTRICTIVE PERICARDITIS
Subahi Saad
Khartoum, Sudan;
Constrictive pericarditis is a commonly missed diagnosis. The
reasons for that are casual clinical examination, casual echo-
cardiography studies, acute presentation, predominant gastric
symptoms and absence of calcification in the chest X-ray in
some patients. In most patients, comprehensive echocardiog-
raphy may provide conclusive evidence of constrictive pericar-
ditis. Therefore echocardiography remains the initial imaging
method of choice for the majority of the patients with pericar-
dial constriction. Additional testing is needed in some clinical
scenarios to make the diagnosis with more confidence .
In this presentation the role of echocardiography and cardi-
ac CT in the diagnosis of constrictive pericarditis is discussed.
An important reason to use echocardiography early in the
diagnostic process is to rule out other common causes of CCF
such as cardiomyopathy and unrecognised valvular disease.
Encasement of the heart by stiff pericardium leads to abrupt
cessation of ventricular diastolic filling, it also isolates the heart
from respiratory changes in intrathoracic pressure and causes
exaggerated ventricular interdependence. These pathophysi-
ological findings are well demonstrated by 2D, M-mode and
Doppler findings. Early diastolic septal noticing, flattening
of the left ventricle posterior wall in diastole and dilatation
of the inferior vena cava are classic M-mode and 2D features
associated with constrictive pericarditis. Doppler interrogation
of transmitral flow velocity shows early rapid restrictive filling
with reciprocal respiratory changes between transmitral and
tricuspid flow or between pulmonary and hepatic flow. Cardiac
computed tomography (CT) on the other hand provides excel-
lent anatomic delineation of the pericardium and enables a
precise measurements of pericardial thickness, it also shows
abnormalities of the contour of pericardium and conical
deformity of the ventricles.
BLOOD PRESSURE PATTERN OF PRESCHOOL CHIL-
DREN IN PORT HARCOURT CITY, NIGERIA
Tabansi Petronila* 1, Onyemkpa Kelechi 2, Otaigbe Barbara1,
Anochie Ifeoma 1
1University of Port Harcourt, Choba, Port Harcourt, Nigeria;
2Maitama District Hospital,
Abuja
Introduction: Blood pressure (BP) is the force exerted by circu-
lating blood on the walls of the blood vessels. It is an important
vital sign in children and adults, and abnormal levels in child-
hood can track into adulthood, especially when persistent.
Sustained high BP levels can result in end-organ damage in
affected individuals, with consequent high morbidity that is
potentially fatal. Precursors of high blood pressure are some-
times present in young children long before manifestation in
adulthood. This suggests the possibility for early identification
of children who are at risk of developing hypertension as adults.
Nigeria has a high prevalence of essential hypertension among
its adult population, yet scarce information exists on the BP
pattern of their preschool sub-population. There is no cure for
essential hypertension, therefore primary prevention by screen-
ing and intervention in childhood is essential to avert tracking
into adulthood.
Aim: To determine the blood pressures pattern in preschool chil-
dren in Port Harcourt City (PHC) and therefore identify those
at potential risk for tracking into adulthood.
Methods: A multistage sampling technique was used to random-
ly select preschool children (2–5 years) from the three school
districts in PHC. Ethical clearance, permission and consent for
the study were obtained from the respective authorities. Pupils’
anthropometry (weight and height) was done and body mass
index (BMI) was calculated. Basal BP was then measured under
resting conditions.
Results: There were 710 pupils, 365 (51.4%) were male and
345 (48.6%) female. Age ranged from two to five years. Mean
systolic BP was 93.2 ± 10.6 mmHg while mean diastolic BP was
58.8 ± 8.0 mmHg. Mean systolic BP of the males was signifi-
cantly higher, at 94.0 ± 9.7 mmHg compared to 92.4 ± 11.5