Prevalence of cardiac valvular abnormalities in juvenile rural population in Kagera district, North Tanzania

Data concerning valvular cardiopathies in rural tropical areas are very few. Congenital heart diseases are probably responsible for the majority of valvular diseases in the newborn, while rheumatic heart disease probably accounts for the majority of acquired valvular cardiopathies, especially in poorest countries where the availability of an echocardiograph, a skilled physician and the time for extensive survey are very scarce. 551 young patients in North Tanzania were screened, performing a cardiac physical examination. All subjects were in apparent good health and notably devoid of fever and major signs of anemia. 15.2% of this population showed clinically significant valvular abnormalities. Two different peaks of prevalence have been represented either in murmurs or in sounds abnormalities prevalence; the ages between 7 and 9 years and between 15 and 20 years are respectively associated to the first and the second cluster of abnormalities. A marked prevalence of murmurs on mitralic focus has been found, suggesting a frequency prevalence of isolated mitralic valvulopathy, even if second sound abnormalities suggest the possibility of a more important aortic involvement. The relatively large percentage of young subjects with significant auscultatory abnormalities underlines the need of a wider diffusion of analyses and instrumentations. The only physical examination could be employed for a first screening to select suspect asymptomatic cases eligible for a secondary instrumental analysis.