Rheumatic Carditis in Children Aged 3 to 15 in the Pediatric Services of the Zinder National Hospital: Epidemiological, Clinical, Paraclinical, Therapeutic and Evolutionary Aspects

Abstract

Introduction. Rheumatic carditis (RC) is the set of acute manifestations of heart damage during acute joint rheumatism (RAA). It is one of the most common cardiovascular diseasesIn children and young adults and is a major public health problem in developing countries. The purpose of our study was to describe the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of CR in the pediatric departments of the Zinder National Hospital (HNZ).  Patients and method. It was a cross-sectional descriptive study with retro-prospective data collection spread over a period of 4 years. It concernedAll children aged 3 to 15 years admitted during the study period to the pediatric departments of the HNZ, suffering from the RAA retained on the modified Jones criteria (2015) and on cardiac echocardiography data. Treatment and analYse data were made using Word, Excel and Epi Info 7.2.5.0.  Results. Our sample consisted of 39 cases of rheumatic heart disease out of a total of 31,951 hospitalized patients, a hospital prevalence of 0.12%.The average annual prevalence was 7.8 cases with two peaks observed in 2021 (13 cases) and 2022 (20 cases). The average age of patients was 9.05±3.3 with extremes of 3 and 15 years. The sex ratio Was Of 1.1 in faVeur of male patients. The majority of the children (54%) came from rural areas and 61% of the parents of the respondents were not in school. More than half (52%) of our patients' parents had a low socio-economic level. The principals X reasons for consultation were dyspnea (64.1%), edema of the lower limbs (10.2%), palpitations (5.1%), cough (41%) and fever (53.8%). The notion of repeated angina was found in 76% of cases. On the paraclinical level, the elevation N of the CRP was observed in 72% of cases, the ASLO rate was positive in 82% of cases. Most patients (78%) had cardiomegaly. The Mitral insufficiency (I M ) Was The most found valve lesion (46.41%).Diuretics (87%), oxygen therapy (41%), antibiotic therapy (100%), hygienic-dietary measures (100%) were the most widely used therapeutic means. The evolution was marked by clinical stabilization in 76% of patients and survey Naked deaths in 23.07% of cases.  Conclusion. Rheumatic heart disease Exists in the Zinder region. Late consultations worsen the prognosis of these patients in whom the surgical indication comes up against a limited technical platform, hence the interest of setting up an effective prevention program against acute joint rheumatism through the correct management of throat angina.