Cardiovascular Journal of Africa: Vol 27 No 5 (September/October 2016)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 5, September/October 2016

290

AFRICA

DS between countries in close proximity, such as the USA

and Mexico or other Latin American countries,

3,4,8,11

it appears

that regional proximity may have a greater effect in cases of

geographical areas with long-standing populations, as in the

Mediterranean area.

About 40.4% of the patients were evaluated during the first six

months of life and all had echocardiograms (100%). As reported

by others,

age at evaluation of CHD is an important factor

for the reduction in mortality and morbidity rates. It has been

suggested that when the associated heart abnormalities are left-

to-right shunts, the prognosis is more favourable than when there

is associated AVSD, which is linked to pulmonary hypertension,

a condition in itself related to high mortality rates.

The high mortality rate observed in our study was associated

with many factors, including non-consent of the parents for

surgery and the fact that a substantial number of cases did not

undergo surgery because of insufficient financial resources (Fig.

2). For various reasons, a substantial number of patients were

lost to follow up. This high rate probably reflects the difficulties

for families and the health system to cope with such diseases in

the context of a developing country (Table 2).

Conclusion

As suggested in the international literature, our study confirmed

that the profile and type of CHDs in DS in the Moroccan

context exhibited slight differences in the distribution of these

CHDs compared with its European neighbours and/or other

Western countries. Further studies are needed to determine

which variables have an impact on these differences.

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