CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 2, March/April 2011
64
AFRICA
of sub-Saharan Africa.
5,6
Therefore, 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
The ethics committee of St Elizabeth Catholic General Hospital
approved the study. Between November 2002 and November
2008, a population of 2 123 patients aged between two months
and 41 years (mean: 10.03
±
9.7 years) was seen in the cardiac
centre for various pathologies. Patients with one or a combina-
tion of the following pathological features: precordial murmurs,
past history of recurrent respiratory heart diseases, clinical indi-
cations of suspicious cardiopathy and/or cardiomegaly on chest
X-ray examination (cardiothoracic index
>
0.55) underwent
further screening tests for detection of congenital heart diseases.
A total of 292 patients (58.2% females and 41.8% males) were
recruited for the study.
Initially, patients underwent clinical examination, followed
by a comprehensive transthoracic Doppler echocardiogram using
an Acuson 4–7 MHz. In addition, a complete two-dimensional
echocardiography examination was performed according to the
recommendations of the American Society of Echocardiography.
Depending on the pathology, patients diagnosed with congen-
ital heart diseases were put on a surgical list for sanitary evacua-
tion to a collaborative centre (Instituto Polyclinico San Donato)
in Italy where corrections of pathology were performed. The
Tertiary Sisters of St Francis and two other charity organisa-
tions, the Cuore Fratello and Associazione Bambini Cardiopatici
nel Mondo, paid for treatments and all inccured costs. Upon
returning to Cameroon, patients were followed up at the Shisong
cardiac centre.
Statistical analysis
Values are expressed as mean
±
standard deviation (SD) and
statistical analyses were performed using the Student’s
t
-test.
SPSS 11 statistical analysis software was used for all analyses
and a
p
-value
≤
0.05 was considered significant.
Results
Two groups of patients were identified based on their diagnoses.
The first group (95.5%) had an echocardiographic diagnosis of
congenital heart disease (
n
=
279) and the second (4.5%) inor-
ganic murmurs (
n
=
13).
There are 10 provincial regions in Cameroon and patients’
geographic origins were distributed as follows (Fig. 1): north
(Maroua and Garoua,
n
=
2), north-west (Bamenda,
n
=
80), litto-
ral (Douala, Nkongsamba and Tiko,
n
=
89), central (Yaounde,
n
=
66), and west (Bafoussam,
n
=
28) regions. The remaining
patients (
n
=
11) were from the other provinces and neighbouring
countries such as Gabon (
n
=
1) and Nigeria (
n
=
3). In addition,
there are also more than 260 tribes in Cameroon. The patients’
tribal origins were (Table 1): Banso (35.3%), Bamileke (32.2%),
Douala (12.7%), Haoussa (8.4%), Ewondo (5.4%), Bakweri
(2.6%) and others (3.4%).
Of the 1 831 patients remaining out of the total patients
consulting (2 123), 321 had rheumatic heart disease (RHD)
while the rest had no heart-related pathologies.
TABLE 1. PATIENT DISTRIBUTION BY TRIBE, AND
TRIBAL REPRESENTATION IN CAMEROON
Tribe
Patients (%)
Tribal representation
in Cameroon (%)
Banso
35.3
12.8
Bamileke
32.2
18.3
Douala
12.7
13
Haoussa
8.4
20.2
Ewondo
5.4
17.6
Bakweri
2.6
8
Others
3.4
10.1
TABLE 2. PERCENTAGE DISTRIBUTION OF CONGENITAL
HEART DISEASES PER PATHOLOGY (
n
=
279 PATIENTS)
Pathology
Percentage (%)
Isolated ventricular septal defect
38.8
Tetralogy of Fallot
26.1
Arterial duct
12.4
Atrioventricular cushion defect
7.3
Isolated atrial septal defect
2.8
Isolated stenosis of the pulmonary artery
2.6
Double-outlet right ventricle
2.1
Atresia of the triscupid valve
1.6
Anormalous pulmonary venous return
1.5
Common arterial trunk
1.3
Congenital mitral valve regurgitation
1.2
Left isomerism
1.2
Coarctation of the aorta
1.1
Fig. 1. Map of Cameroon showing the provincial areas
as well as the neighbouring countries of the patients
included in the study.
CHAD
NIGERIA
CENTRAL
AFRICAN
REPUBLIC
YAOUNDÉ
Maroua
Garoua
Ngaoundéré
Bamenda
Bafoussam
Nkongsamba
Douala
REP.
OF THE
CONGO
GABON
Lake
Chad
Tiko
Bight
of
Biafra
EQUATORIAL
GUINEA
0 100 200 km
0
100
200 ml
Kumbo
Kribi
