Children's Heart Disease in Sub-Saharan Africa: Challenging the Burden of Disease

ABSTRACT

Children with heart disease in Africa have little or no access to treatment of any kind; and cardiac surgical services are virtually absent outside a handful of centres in a few of the wealthier nations. There is little reliable data concerning the prevalence of congenital or acquired heart disease in African children; but there is sufficient information to indicate that the burden of cardiac disease is vast. This major non-communicable disease is largely hidden; overshadowed by the incidence of communicable diseases. There is as yet little evidence of the hoped-for epidemiological transition toward non-communicable diseases amongst children in Africa. The burden of congenital heart disease is only part of the problem; with rheumatic heart disease (RHD) remaining the commonest cardiac problem; related to poor socioeconomic conditions. RHD is the most preventable form of cardiac disease; yet there is little preventive work being done. The many obstacles to developing paediatric cardiac care are discussed; and some possible ways forward are proposed