Bodian M, Ngaïdé A A, Mbaye A, Sarr S A, Jobe M, Ndiaye M B, Kane A D, Aw F, Gaye N D, Ba F G, Bah M B, Tabane A, Dioum M, Diagne D, Diao M, Diack B, Sarr M, Kane A, Bâ S A
Clinique cardiologique, CHU Aristide Le Dantec, Dakar, Sénégal.
Clinique cardiologique, Hôpital Général de Grand Yoff, Dakar, Sénégal.
Bull Soc Pathol Exot. 2015 Feb;108(1):32-5. doi: 10.1007/s13149-014-0410-5. Epub 2014 Dec 17.
Congenital heart diseases are one of the major cardiovascular diseases in developing countries. Most prevalence studies were based on clinical examination of children with echocardiographic confirmation of suspected cases and underestimate its prevalence. The objective of this study was to investigate the prevalence of congenital heart disease in "daara" (Koranic schools) in the city of Dakar and its suburbs on the basis of clinical examination and Doppler echocardiography in school children. This cross-sectional survey was carried out from 9(th) August to 24(th) December 2011, and included a population of 2019 school children aged 5 to 18 years in 16 selected "daaras" under the Academic Inspectorate of Dakar and its suburbs. Anamnestic, clinical and echocardiographic data were recorded in a validated questionnaire. A p < 0.05 was considered to be statistically significant in bivariate analysis. 2 019 school children were included out of which 60.1% were male (sex-ratio: 0.66). The average age was 9.7 years (± 3.3 years). 18 cases of congenital heart diseases were detected being a prevalence of 8.9 per 1 000 (95 % CI: 1.8 to 7.9). This included 6 cases of inter-atrial septal aneurysm, 5 cases of peri-membranous ventricular septal defects, 4 cases of patent ductusarteriosus and 3 cases of tetralogy of Fallot. Factors correlated with the presence of congenital heart disease were ageless than 8 (p <0.001) and residence in the suburbs of Dakar (p <0.001). We also detected 10 cases of rheumatic valvular disease, a prevalence of 4.9 per 1 000 (95% CI: 2.4 to 9.1). Our study shows a high prevalence of congenital heart diseases, which is almost identical to the WHO estimates and that ultrasound screening is more sensitive than clinical screening. Reducing the prevalence of these diseases requires implementation of appropriate policies, focusing on awareness and early detection.
先天性心脏病是发展中国家主要的心血管疾病之一。大多数患病率研究基于对疑似病例进行超声心动图确认的儿童的临床检查，因而低估了其患病率。本研究的目的是通过对在校儿童进行临床检查和多普勒超声心动图，调查达喀尔市及其郊区“古兰经学校”中先天性心脏病的患病率。这项横断面调查于2011年8月9日至12月24日进行，纳入了达喀尔及其郊区学术监察局下属16所选定“古兰经学校”的2019名5至18岁在校儿童。通过一份经过验证的问卷记录病史、临床和超声心动图数据。在双变量分析中，p<0.05被认为具有统计学意义。纳入了2019名在校儿童，其中60.1%为男性（性别比：0.66）。平均年龄为9.7岁（±3.3岁）。检测到18例先天性心脏病，患病率为每1000人中有8.9例（95%可信区间：1.8至7.9）。其中包括6例房间隔瘤、5例膜周部室间隔缺损、4例动脉导管未闭和3例法洛四联症。与先天性心脏病存在相关的因素是年龄小于8岁（p<0.001）以及居住在达喀尔郊区（p<0.001）。我们还检测到10例风湿性瓣膜病，患病率为每1000人中有4.9例（95%可信区间：2.4至9.1）。我们的研究表明先天性心脏病患病率很高，几乎与世界卫生组织的估计相同，而且超声筛查比临床筛查更敏感。降低这些疾病的患病率需要实施适当政策，重点是提高认识和早期发现。
