East African Medical Journal

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A profile of demographic, geographic, and socioeconomic risk factors among children with congenital and rheumatic heart disease in western Kenya

M Koech, G.T.K. Ngeno, B.A. Knettel, E Jung, G.S. Bloomfield


Objectives: Congenital heart disease (CHD) and rheumatic heart disease (RHD) are major health concerns among children in sub-Saharan Africa. Poverty is a key predictor of both conditions, but the mechanisms of that association are not well understood.

Design: We conducted a retrospective review of medical records of children diagnosed with CHD or RHD to identify associations between demographic, geographic, and socioeconomic variables and the two diseases.

Setting: Medical records were obtained for care received at the Moi Teaching and Referral Hospital (MTRH), a public hospital in Eldoret, western Kenya.

Participants: Our sample included 180 children with a mean age of 9 years.

Main Outcome Measures: We examined multiple potential predictors associated with a diagnosis of CHD or RHD, including the child’s household size, family socioeconomic status, age, gender, geographical distribution, and racial/ethnic identity.

Results: Siblings per household was greater amongst children with RHD (4.6) than among those with CHD (3.7). Patients were of low socio-economic status in both groups. The gender, geographical, and ethnic composition were similar between the CHD and RHD groups. Age and family size were significantly higher among children with RHD as compared to CHD.

Conclusion: Future exploration of the environmental factors associated with childhood CHD and RHD will complement studies of genetic and biological risk factors and can advance understanding of the determinants of cardiac diseases in western Kenya. These data may inform early intervention, prevention, and screening efforts for children at risk of both conditions.

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