1. TITLE - CHILDHOOD ACQUIRED HEART DISEASES IN JOS,
NORTH CENTRAL NIGERIA
JOURNAL – NIGERIAN MEDICAL JOURNAL
AIM – TO COMPARE PATTERNS OF CHILDHOOD ACQUIRED
HEART DISEASE PRESENTING AT JUTH WITH HISTORICAL
AND CONTEMPORARY PATTERNS IN OTHER PARTS OF
THE COUNTRY AND TO HIGHLIGHT POSSIBLE REGIONAL
DIFFERENCES AND CHANGES IN TREND
AUTHORS – FIDELIA BODE-THOMAS, OLUKEMI IGE,
CHRISTOPHER YILGWAN

2. INTRODUCTION
• CHILDHOOD ACQUIRED HEART DISEASES ARE
STILL A MAJOR PUBLIC HEALTH PROBLEM IN THE
DEVELOPING WORLD
• FOUR DECADES AGO, IDIOPATHIC
CARDIOMEGALY, EMF, RHD WERE THE MOST
PREVALENT CHILDHOOD AHDs AMONG
NIGERIAN CHILDREN, BUT RECENT REPORTS
INDICATE PATTERNS HAVE CHANGED
• THE STUDY WAS A 10-YEAR RETROSPECTIVE
REVIEW OF ECHO RECORDS

3. MATERIALS AND METHODS
• A HOSPITAL-BASED RETROSPECTIVE REVIEW BASED
PRIMARILY ON ECHO DIAGNOSIS
• DEC 1999 – NOV 2009
• 3 ECHO MACHINES USED OVER THIS PERIOD (16-
MONTH PERIOD WITHOUT ECHO)
• 4 PEDIATRICIANS EXAMINED OVER THIS PERIOD
• ECHO DGX BASED ON DIAGNOSTIC CRITERIA FOR EACH
AHD
• EXCLUSION CRITERIA - >18YRS, CHD, NORMAL ECHO
• EPI INFO USED TO ANALYSE DATA
• P<0.05

4. RESULTS
• 580 CHILDREN HAD ECHOs OVER THE PERIOD
• CHD ALONE – 390
• AHD +/- CHD – 174
• NORMAL ECHO – 16
• 175 DIAGNOSED WITH AHD
• 167 – AHD
• 7 – AHD + CHD
• 1 – IRREFUTABLE CLIN FX KAWASAKI + NORMAL ECHO
• F(95/54.3%) > M (80/45.7%)
• AGE RANGE – 4WEEKS TO 18YRS. MEAN – 9.84
• NO SIGNIFICANT DIFF IN MEAN AGES FOR MALE
AND FEMALE

5. INDICATIONS FOR ECHO

6. RESULTS
• RHD COMMONEST AHD. SEEN IN 101 (57.7%).
NONE OF THEM <5YRS. MV MOSTLY
AFFECTED (95%)
• CARDIOMYOPATHY 2ND
COMMONEST. SEEN IN
37 (21.1%). COMMONEST AHD IN UNDER-5s.
• COR PULMONALE AND PERICARDIAL DISEASE
IN 16 (9.1%) AND 15 (8.6%) RESPECTIVELY
• AORTIC ANEURYSM, NDCM, ARVD, EMF

7. TYPES & SEX DISTRIBUTION OF AHD IN
CHILDREN

8. AGES AT ECHO DIAGNOSIS OF
COMMONEST AHDs

9. DISCUSSION
• FEWER AHDs THAN CHDs. AGREED WITH OTHER STUDIES.
• RHD MOST FREQUENT AHD AND OCCURED MORE IN FEMALES.
OTHER STUDIES MOSTLY REPORT SAME AND ALSO RHD MORE
SEVERE IN FEMALES. IN DEVELOPED COUNTRIES - KAWASAKI DX
COMMONEST AHD
• MV MOSTLY AFFECTED IN RHD. IN TANDEM WITH OTHER STUDIES
• COR PULMONALE RATE WAS 8.7%, MUCH LESS THAN REPORTED
ELSEWHERE IN NIGERIA
• FEWER CASES OF PERICARDIAL DX ENCOUNTERED AS COMPARED
TO OTHER REPORTS
• SINGLE CASE OF EMF. 52 CASES REPORTED IN A STUDY IN 1982 IN
IBADAN. REASON – IMPROVEMENT IN NUTRITION AS DEFICIENCY
IN LEUCINE, VALINE & TRYPTOPHAN ARE KNOWN ETIOLOGIC
FACTORS

10. CONCLUSION
• RHD STILL MOST COMMON AHD
• URGENT NEED FOR IMPROVEMENT IN LIVING
CONDITIONS, INSTITUTION OF A PRIMARY
PREVENTION PROGRAM AIMED AT PROMPT AND
APPROPRIATE RX OF STREPTOCOCCAL
SORETHROAT
• VIGOROUS PURSUIT OF THE MDGs
• MULTICENTER COLLABORATIVE STUDIES AND
COMMUNITY SURVEYS ARE NECESSARY TO
ASCERTAIN TRUE EPID OF AHD IN NIGERIAN
CHILDREN

11. COMMENTS/CRITIQUE
• AIM ACHIEVED
• ATTEMPTS MADE AT IDENTIFYING
SHORTCOMING/LIMITATIONS
• TITLE IS QUITE VAGUE
• STUDY DID NOT IDENTIFY AHD REFERRALS
FROM OTHER REGIONS/GEO-POLITICAL
ZONES

12. THANK YOU