Cardiac diseases of surgical interest are extremely common in Sub-Saharan Africa.
Group A Beta-hemolytic streptococci, responsible for the common “strep throat” pharyngitis, frequently lead to rheumatic fever with cardiac involvement. The absence of facilities able to provide adequate prophylaxis and treatment makes rheumatic fever the leading cause of cardiovascular diseases observed in children and teenagers in Africa, particularly in the age group 5 to 15 years.
Although strep throat pharyngitis is widespread in industrialized countries, where medical treatment is usually available, rheumatic fever is a rather uncommon event, occurring only in 1 case every 100,000 people. On the other hand, in Sudan 1 every 1000 people is affected by the disease (source: M.R. Essop, Circulation 2005; 112: 3584-3591). According to the World Health Organization Report on Rheumatic Diseases, 60 percent of all cardiovascular diseases in children and young adults are caused by rheumatic fever and its effects on the heart.
Current estimates for cardiovascular diseases in Africa stand at 300,000 deaths every year, and projections show that roughly one million people in Africa will be in need of surgery in the next 5 to 20 years (source: Cardiovascular Diseases in the African Region: Current Situation and Perspectives, World Health Organization, 2005).