撒哈拉以南非洲地区的风湿性瓣膜病：喀麦隆城市学校的横断面研究。

Rheumatic Valvulopathy in Sub-Saharan Africa: A Cross-Sectional Study of Cameroonian Urban Schools.

作者信息

Nganou-Gnindjio Chris Nadège, Ladibe Anicet Gakdang, Nyaga Joël Marie Obama, Ngambono Sandrine Laure, Tasong Loic Alban, Elong Jules Thierry, Nzongang Hursul Geffried, Kamdem Félicité, Chelo David

机构信息

Faculty of Medicine and Biomedical Sciences of the University of Yaoundé 1, Cameroon.

Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.

出版信息

Glob Heart. 2025 Mar 27;20(1):36. doi: 10.5334/gh.1414. eCollection 2025.

DOI:10.5334/gh.1414

PMID:40161864

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11951962/

Abstract

BACKGROUND

Rheumatic heart disease is a post-infectious sequelae of acute rheumatic fever resulting from an abnormal immune response to streptococcal pharyngitis that triggers valvular damage. It is the most commonly acquired heart disease in children, particularly in developing countries.

OBJECTIVE

This study aimed to describe rheumatic valvulopathy among schoolchildren and adolescents in Yaoundé, Cameroon.

METHODS

A cross-sectional echocardiography study was conducted from December 2022 to May 2023 among students aged 5 to 19 in primary and secondary schools in Yaoundé, Cameroon. All students with informed parental consent and who agreed to participate in the study were included. The data collected were entered and analysed using SPSS statistics software version 23.0. The association between the qualitative variables was verified using Odd-Ratio with a 95% confidence interval and a significance level of 5%.

RESULTS

Of the 1020 children recruited, 133 (13.03%) had rheumatic heart disease with a mean age of 11.69 ± 4.09 years. The sex ratio (M/F) was 0.56. Most of the participants lived in urban slums (60.9%). Cardiac murmurs were detected in 23 (17.3%) participants during auscultation, with the majority (78.3%) being located at the mitral focus. The definitive form of rheumatic heart disease was observed in 69 (51.9%) children. Mitral involvement was observed in all participants. Mitral valve abnormalities were primarily characterized by mitral insufficiency in 124 (93.2%) participants, valvular thickening (74.4%), and restriction of movement (42.9%). Age between 10 and 14 years [OR = 2.36; CI = (1.11-5.01)] and residence in urban slums [OR = 2.14; CI = (1.05-4.36)] were significantly associated with an increase in the occurrence of definitive rheumatic valve disease.

CONCLUSION

Rheumatic heart disease is common among schoolchildren in this setting. It systematically affects the mitral valve. The clinical presentation is usually silent at first.

摘要

背景

风湿性心脏病是急性风湿热的感染后后遗症，由对链球菌性咽炎的异常免疫反应引发，进而导致瓣膜损害。它是儿童中最常见的后天性心脏病，在发展中国家尤为如此。

目的

本研究旨在描述喀麦隆雅温得学童和青少年中的风湿性瓣膜病情况。

方法

2022年12月至2023年5月，在喀麦隆雅温得的中小学对5至19岁的学生进行了一项横断面超声心动图研究。纳入所有获得家长知情同意并同意参与研究的学生。收集的数据使用SPSS统计软件23.0进行录入和分析。使用比值比及95%置信区间和5%的显著性水平来验证定性变量之间的关联。

结果

在招募的1020名儿童中，133名（13.03%）患有风湿性心脏病，平均年龄为11.69±4.09岁。性别比（男/女）为0.56。大多数参与者居住在城市贫民窟（60.9%）。听诊时在23名（17.3%）参与者中检测到心脏杂音，其中大多数（78.3%）位于二尖瓣区。69名（51.9%）儿童观察到风湿性心脏病的确诊形式。所有参与者均观察到二尖瓣受累。二尖瓣异常主要表现为二尖瓣关闭不全，124名（93.2%）参与者有此表现，瓣膜增厚（74.4%），活动受限（42.9%）。10至14岁[比值比=2.36；置信区间=（1.11 - 5.01）]以及居住在城市贫民窟[比值比=2.14；置信区间=（1.05 - 4.36）]与确诊的风湿性瓣膜病发生率增加显著相关。