Namuyonga Judith, Mocumbi Ana Olga
Uganda Heart Institute, Kampala, Uganda.
Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Uganda.
Int J Pediatr. 2021 Nov 30;2021:9998070. doi: 10.1155/2021/9998070. eCollection 2021.
Pulmonary hypertension (PH) is a complex puzzle in Africa, especially among children who present with a cocktail of issues including recurrent pulmonary infections, unoperated congenital heart disease, and advanced rheumatic heart disease. Sickle cell anemia and neonatal complications of transiting from fetal circulation also contribute to the burden of pulmonary hypertension. Mortality from pulmonary arterial hypertension (PAH) remains high in Africa (18-21%), claiming sufferers in the first 6 months after diagnosis. Unfortunately, PH remains underreported in sub-Saharan Africa since many centers lack the capacity to diagnose and confirm it by the recommended gold standard, right heart catheterization. The unresolved burden of unoperated congenital heart lesions and rheumatic heart disease, among other preventable causes, stand out as major causes of PH in African children. This paper highlights pediatric PAH as a result of major gaps in care and illustrates the need for its prevention as well as for the promotion of research into the most important drivers, to prevent premature mortality in the continent.
肺动脉高压（PH）在非洲是一个复杂的难题，尤其是在那些存在一系列问题的儿童中，这些问题包括反复肺部感染、未手术的先天性心脏病和晚期风湿性心脏病。镰状细胞贫血以及从胎儿循环过渡而来的新生儿并发症也加重了肺动脉高压的负担。在非洲，肺动脉高压（PAH）的死亡率仍然很高（18%-21%），在诊断后的前6个月就夺去了患者的生命。不幸的是，由于许多中心缺乏通过推荐的金标准——右心导管检查来诊断和确认肺动脉高压的能力，在撒哈拉以南非洲地区，肺动脉高压仍然报告不足。未手术的先天性心脏病变和风湿性心脏病等可预防病因造成的负担尚未解决，这是非洲儿童肺动脉高压的主要原因。本文强调了由于护理方面的重大差距导致的儿童PAH，并说明了预防PAH以及推动对最重要驱动因素进行研究的必要性，以防止该大陆的过早死亡。
