PMID- 31143638
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2223-3652 (Print)
IS  - 2223-3660 (Electronic)
IS  - 2223-3652 (Linking)
VI  - 9
IP  - 2
DP  - 2019 Apr
TI  - Patterns, outcomes and trends in hospital visits of un-operated and operated 
      children with rheumatic heart disease in Sudan.
PG  - 165-172
LID - 10.21037/cdt.2018.12.09 [doi]
AB  - BACKGROUND: Rheumatic heart disease (RHD) is an important public health problem 
      in Sudan. METHODS: Clinical and echocardiographic findings from an RHD registry 
      in Khartoum (January 2005-March 2018) are described. Operated and un-operated 
      children were prospectively followed. The quality of life (QOL) for children who 
      had surgery was evaluated using pediatric QOL cardiac module. RESULTS: A total of 
      818 children (51% males) were included, patients were clustered in White Nile and 
      Kordofan area. RHD was found in 78% and acute rheumatic fever (ARF) in 22% of 
      cases. RHD was severe in 65% and the most common lesion was mitral regurgitation 
      (MR) in 37%. Follow-up of 107 un-operated children for a mean of 2 years revealed 
      major complications in 38% including a mortality of 14%. Severe valve dysfunction 
      tended to remain unchanged. There were 3 deaths in children with severe valve 
      lesions immediately following benzathine penicillin injections. Only 19% of 
      patients underwent surgery with an average post-operative mortality of 10.5% in 
      the last 8 years. Of those, only 34 were reached for follow-up (23%), all were in 
      New York Heart Association (NYHA) class 1, however adverse outcomes were observed 
      including noncompliance with benzathine penicillin and warfarin (51% and 29% 
      respectively) and more than mild valve dysfunction in 35%. All children who had 
      valve surgery have a good QOL scores. In the last 3 years, the outpatient visits, 
      admissions and mortality rates decreased by 20%, 48% and 22% respectively. 
      CONCLUSIONS: RHD is clustered in certain areas and presents with severe valve 
      lesions with a high mortality for un-operated patients. Operative mortality 
      improved over the last years but the follow-up rates are poor and adverse 
      outcomes are common. There is an apparent trend of decline in the number of 
      patients with RHD seen at referral hospitals.
FAU - Ali, Sulafa
AU  - Ali S
FAU - Karadawi, Noha
AU  - Karadawi N
AD  - Department of Pediatric Cardiology, Jafaar Ibn Ouf Children's Hospital and Sudan 
      Heart Center, Khartoum, Sudan.
FAU - Elhassan, Nezar B
AU  - Elhassan NB
FAU - Ahmed, Amal Ahmed M
AU  - Ahmed AAM
FAU - Boctor, Maha
AU  - Boctor M
FAU - Awadalla, Heitham
AU  - Awadalla H
FAU - Ahmed, Mohamed H
AU  - Ahmed MH
AD  - Department of Medicine and HIV metabolic clinic, Milton Keynes University 
      Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire, UK.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Cardiovasc Diagn Ther
JT  - Cardiovascular diagnosis and therapy
JID - 101601613
PMC - PMC6511682
OTO - NOTNLM
OT  - Rheumatic heart disease (RHD)
OT  - Sudan
OT  - outcomes
OT  - trends
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2019/05/31 06:00
MHDA- 2019/05/31 06:01
PMCR- 2019/04/01
CRDT- 2019/05/31 06:00
PHST- 2019/05/31 06:00 [entrez]
PHST- 2019/05/31 06:00 [pubmed]
PHST- 2019/05/31 06:01 [medline]
PHST- 2019/04/01 00:00 [pmc-release]
AID - cdt-09-02-165 [pii]
AID - 10.21037/cdt.2018.12.09 [doi]
PST - ppublish
SO  - Cardiovasc Diagn Ther. 2019 Apr;9(2):165-172. doi: 10.21037/cdt.2018.12.09.