Infective endocarditis in children with heart diseases at Jakaya Kikwete Cardiac Institute, Tanzania: a cross-sectional study

Abstract

BACKGROUND: Infective endocarditis (IE) in children with pre-existing heart conditions is a life-threatening disease entity associated with significant morbidity and mortality. In our cardiac setting, the management outcomes of children with IE are not well documented. We therefore aimed to document the clinical profile and treatment outcomes of children with IE attended at the Jakaya Kikwete Cardiac Institute (JKCI). METHODS: This was a hospital-based cross-sectional study with longitudinal follow-up conducted among children with IE diagnosed by Modified Duke's Criteria at the JKCI from November 2021 to November 2023. A structured questionnaire was used to collect patients' socio-demographic and clinical data. RESULTS: During the study period, 1,546 children were admitted to the JKCI. A total of 30 children with IE were enrolled, of these half (n = 16, 53%) were aged 10 to 18 years, with a median of 10 yrs (Inter quartile range, IQR: 6.5-12.2 yrs). Twelve children (40%) and nearly half (n = 14, 47%) had fever and used antibiotic therapy respectively. Majority of participants had anaemia (n = 26, 87%) and heart failure (n = 21, 70%). Nine children (30%) had positive blood cultures and S. aureus was the most frequently isolated organism (n = 7). Ten patients (33%) developed acute kidney injury (AKI), and eleven (37%) children died during the hospital stay. CONCLUSION: In our setting, in-hospital mortality due to IE among children with heart diseases is high. Heart failure and anaemia were the common presentations of IE. Furthermore, AKI was observed to be the leading in-hospital non-cardiac complication.