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苏丹喀土穆州儿科扩张型心肌病:一项前瞻性研究。

Paediatric dilated cardiomyopathy in Khartoum state, Sudan: a prospective study.

机构信息

Department of Paediatrics and Child Health, University of Khartoum Faculty of Medicine, Khartoum, Sudan.

Ahmed Gasim Paediatric Hospital, Khartoum North, Khartoum, Sudan.

出版信息

BMJ Paediatr Open. 2021 Apr 27;5(1):e000970. doi: 10.1136/bmjpo-2020-000970. eCollection 2021.

Abstract

BACKGROUND

Dilated cardiomyopathy (DCM) is a disease of the heart muscle that affects ventricular function; it is a debilitating disease that can lead to heart failure and death in children. There is a lack of good epidemiological data about paediatric DCM in Sudan or in sub-Saharan Africa.

OBJECTIVE

To study the incidence, causes and outcome of DCM among children in Sudan.

METHODS

A prospective cross-sectional study that was conducted in three paediatric hospitals in Khartoum state, Sudan over the period of 6 months.

RESULTS

During the study period, 55 children were seen with the diagnosis of DCM; The female: male ratio was 1.9:1. The incidence of DCM in Khartoum state was found to be 1.4 cases per 100 000 children per year, 10 children (18 %) were diagnosed in the first year of their life. Twenty-seven children (49 %) showed evidence of failure to thrive, being below the fifth percentile for weight. The most common cause of DCM was found to be postviral in 27 children (49%), followed by Idiopathic in 25 children (45%). The most common presentation was the shortness of breath in 53 children (97%), on echocardiography 26 children (47 %) showed evidence of severe left ventricular impairment and 23 children (42%) showed moderate ventricular impairment. Regarding the outcome, 8 children (15%) recovered, the condition of 11 children (20%) remained static and there were 36 deaths (65%).

CONCLUSION

The incidence of DCM in Sudanese children was found to high with a higher mortality compared with middle-income and high-income countries; Improvement in the entire health system is needed to tackle this condition.

摘要

背景

扩张型心肌病(DCM)是一种影响心室功能的心肌疾病;它是一种使人虚弱的疾病,可导致儿童心力衰竭和死亡。在苏丹或撒哈拉以南非洲,缺乏关于儿科 DCM 的良好流行病学数据。

目的

研究苏丹儿童 DCM 的发病率、病因和结局。

方法

这是一项在苏丹喀土穆州的三家儿科医院进行的为期 6 个月的前瞻性横断面研究。

结果

在研究期间,有 55 名儿童被诊断为 DCM;男女比例为 1.9:1。喀土穆州的 DCM 发病率为每年每 10 万名儿童 1.4 例,10 名儿童(18%)在出生后的第一年被诊断出患有该病。27 名儿童(49%)表现出生长不良的迹象,体重低于第 5 个百分位。DCM 的最常见病因是 27 名儿童(49%)的病毒后病因,其次是特发性病因在 25 名儿童(45%)中发现。最常见的表现是 53 名儿童(97%)的呼吸急促,在超声心动图上,26 名儿童(47%)显示出严重的左心室功能障碍的证据,23 名儿童(42%)显示出中度心室功能障碍。关于结局,有 8 名儿童(15%)康复,11 名儿童(20%)病情稳定,有 36 名儿童(65%)死亡。

结论

苏丹儿童 DCM 的发病率较高,死亡率高于中高收入国家;需要改善整个卫生系统来应对这种情况。

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