Pulmonary Hypertension in Children across Africa: The Silent Threat

Namuyonga, Judith; Mocumbi, Ana Olga

doi:10.1155/2021/9998070

Cited by 4 publications

(2 citation statements)

References 78 publications

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“…Our third most prevalent AHD, pulmonary hypertension, is increasingly recognised as an important cause of childhood mortality and morbidity; in children, it stems from the highest number of unrepaired CHD and RHD ( 61 62 ). Since our cohort records a high rate of pulmonary hypertension, close follow-up is essential.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of Heart Diseases in Children in a National Cardiac Referral Center Tanzania, Eastern Africa: A Six-Year Overview

Majani,

Koster,

Kalezi

et al. 2024

Global Heart

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Background: While communicable diseases have long been the primary focus of healthcare in Africa, the rising impact of paediatric and congenital heart disease (CHD) cannot be overlooked. This research aimed to estimate the frequency and pattern of heart diseases in children who underwent their first echocardiography at a national cardiac referral hospital in Tanzania. Methods: A retrospective observational study was conducted on children aged 0 to 18 years referred for first-time cardiological evaluation from January 2017 to December 2022. Retrieval of social and echocardiogram data and descriptive analysis were performed. Results: There were 6,058 children with complete reports. Of these, 52.8% (3,198) had heart disease, of whom 2,559 (80%) had CHD, while (340/639; 53.2%) with acquired heart disease (AHD) had rheumatic heart disease (RHD). Children with CHD had a median age 1.0 years (IQR: 0.3–3.5) and were predominantly 51.2% male. Children with RHD had a median age 9.7 years (IQR: 3.2–13.8) with equal gender distribution. Shunt lesions were common in 1,487 (58.1%), mainly VSD 19.3%, PDA 19.1%, ASD 15.1%, and atrioventricular septal defect (AVSD) 4.6%. Pulmonary valve stenosis was in 97 (3.8%). Around 35% (718) had cyanotic CHD, with TOF being most common (13.3%), followed by double outlet right ventricle (DORV) (3.6%). Compared to global average truncus arteriosus was higher in 69 (2.3%) children. In contrast, TGA and hypoplastic left heart syndrome (HLHS) were lower than the estimated global average seen in 2.3% and 0.5% of the cases, respectively. Atresia of the right-side valves was more common (174 vs. 24), and approximately 40% of the patients referred for first-time echocardiographic evaluation required hospitalization. Conclusion: Congenital heart disease is the primary cause of heart disease in children presenting at a national referral hospital, surpassing RHD. With its distinct distribution pattern, acyanotic lesions are more frequent than cyanotic heart diseases. The observed late referral tendencies suggest improving the referral system, enhancing CHD awareness among healthcare professionals, and instituting nationwide screening programs.

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Section: Discussionmentioning

confidence: 99%

Spectrum of Heart Diseases in Children in a National Cardiac Referral Center Tanzania, Eastern Africa: A Six-Year Overview

Majani,

Koster,

Kalezi

et al. 2024

Global Heart

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“…Moreover, a study by Namuyonga and colleagues examined the impact of PH in underserved populations, specifically South African children. This case series highlighted the unique challenges and disparities in pediatric care, emphasizing the broader societal impact of the disease, especially in resource-limited settings [12].…”

Section: Tablementioning

confidence: 99%

Classification, Diagnosis, and Medical Treatment of Pulmonary Hypertension

Tenpas,

Panahi,

Udeani

et al. 2024

New Insights on Pulmonary Hypertension

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Pulmonary hypertension is a condition characterized by elevated blood pressure in pulmonary arteries due to increased muscle mass of vessel walls, leading to arterial constriction and reduced blood oxygenation. Commonly classified into five major groups, pulmonary hypertension is often viewed as quite rare when, in fact, it is far more common than traditionally advertised. It is also an extremely debilitating disease with far-reaching economic, societal, personal, and psychosocial impacts, especially in underserved populations. Though 10 FDA-approved medications—targeting four different biological pathways—have come to market over the last 20 years, more recent research has focused on complex signaling pathways regulating hypoxic and metabolic signaling, proliferation, apoptosis, senescence, and inflammation. In this chapter, we provide an overview of pulmonary hypertension’s prevalence and widespread impact, its underlying pathophysiology and clinical presentations, currently recognized treatment strategies, recommended regimens in special populations, and emerging therapeutic options and fields of research.

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The Synergistic Threat of Pollution and Climate Change

Stewart

2024

Sustainable Development Goals Series

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While it might be tempting to simplify our interactions with weather and longer-term climatic conditions as a simple byproduct of varying atmospheric conditions, this would be a mistake. As will be outlined in this chapter, air pollution (a nasty consequence of the mainly human activities and technology driving climate change!) by itself, is likely cardio-toxic. Moreover, concentrations of outdoor air pollution and its impact on the cardiovascular system varies according to the prevailing climatic conditions, topography and human structures/activity. Other forms of pollution, including indoor air pollution, metal pollutants, microplastics and noise pollution are also important factors in eroding the capacity of an individual’s cardiovascular (and broader cardiopulmonary) system to maintain homeostasis when confronted with provocative climatic conditions. It is for this reason that ‘pollution’ has been elevated to the status of being a “non-traditional, major risk factor” for cardiovascular disease. But how much does climate and climate change influence it’s impact on our heart health? To answer this question, in this chapter the synergistic threat of pollution as both a consequence and cause of climate change will be explored.

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Pulmonary Hypertension in Children across Africa: The Silent Threat

Cited by 4 publications

References 78 publications

Spectrum of Heart Diseases in Children in a National Cardiac Referral Center Tanzania, Eastern Africa: A Six-Year Overview

Spectrum of Heart Diseases in Children in a National Cardiac Referral Center Tanzania, Eastern Africa: A Six-Year Overview

Classification, Diagnosis, and Medical Treatment of Pulmonary Hypertension

The Synergistic Threat of Pollution and Climate Change

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