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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Incidence and characteristics of newly diagnosed rheumatic heart disease in Urban African adults: Insights from the Heart of Soweto Study
European Heart Journal, Volume 31, No. 6, Year 2010
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Description
Aims Little is known on the incidence and clinical characteristics of newly diagnosed rheumatic heart disease (RHD) in adulthood from urban African communities in epidemiologic transition. Methods and results Chris Hani Baragwanath Hospital services the black African community of 1.1 million people in Soweto, South Africa. A prospective, clinical registry captured data from all de novo cases of structural and functional valvular heart disease (VHD) presenting to the Cardiology Unit during 2006/07. We describe in detail all cases with newly diagnosed RHD. There were 4005 de novo presentations in 2006/07 and 960 (24) had a valvular abnormality. Of these, 344 cases (36) were diagnosed with RHD. Estimated incidence of new cases of RHD for those aged >14 years in the region was 23.5 cases/100 000 per annum. Most were black African females (n = 234-68) with a similar age profile to males [median 41 (interquartile range 30-55) years vs. 42 (interquartile range 31-55) years]. The predominant valvular lesion (n = 204, 59) was mitral regurgitation (MR), with 48 (14) and 43 (13) cases, respectively, having combination lesions of aortic plus MR and mixed mitral VHD. Impaired systolic function was found in 28/204 cases (14) of predominant MR and in 23/126 cases (18) with predominant aortic regurgitation. Elevated right ventricular systolic pressure >35 mmHg (62 cases), atrial fibrillation (34 cases), and anaemia (27 cases) were found in 18, 10, and 8 of 344 RHD cases, respectively. Subsequent valve replacement/repair was performed in 75 patients (22). A total of 90 cases (26) were admitted within 30 months of initial diagnosis for suspected bacterial endocarditis. Conclusion These data reveal a high incidence of newly diagnosed RHD within an adult urban African community. These data argue strongly for the first episode of RHD to be made a notifiable condition in high burden countries in order to ensure control of the disease through register-based secondary prophylaxis programmes. © The Author 2009.
Authors & Co-Authors
Sliwa, Karen S.
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Carrington, Melinda J.
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Australia, Melbourne
Baker Heart and Diabetes Institute
Mayosi, Bongani M.
South Africa, Observatory
Groote Schuur Hospital
Zigiriadis, Elias
South Africa, Johannesburg
Charlotte Maxeke Johannesburg Academic Hospital
Mvungi, Robert
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Stewart, Simon D.
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Australia, Melbourne
Baker Heart and Diabetes Institute
Statistics
Citations: 230
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1093/eurheartj/ehp530
ISSN:
0195668X
e-ISSN:
15229645
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Cohort Study
Study Locations
South Africa
Participants Gender
Female