Boy's five-year battle with rheumatic heart disease

Nakuru, Friday April 14, 2023

K.N.A By Anne Mwale/Dennis Rasto

Favour Gathura is visibly exhausted. He walks sluggishly, stopping after every few steps to catch his breath.

His frail frame is covered by a blue spotted shirt and a black trouser. Although the morning weather is chilly, he seems to feel a bit colder. As he sprawls onto a seat at their Ndege Ndimu home one can easily tell he is out of breath.

Speaking in a shaky voice that sometimes fades into a whisper, you have to listen keenly to grasp every word he is saying.

Master Gathura, 12, has just marked a fifth year living with rheumatic heart disease, which according to the World Heart Federation, accounts for 200,000 heart disease cases reported in Kenya annually.

“I started experiencing fatigue, night sweats and difficulty in breathing. Trips to several doctors yielded nothing conclusive as they each made different diagnoses,” he says.

It was only when he went for an electrocardiogram (ECG) at the Kenyatta National Hospital that he was able to find out what the condition was.

The condition has exerted a heavy toll on Gathura, a former promising footballer who aspires to join Kenya Defense Forces on completion of his education.

“Going up a flight of stairs is difficult. Sleeping is hard as my heart beats so fast, leaving me breathless and uncomfortable,” he says.

Just last month, the youngster was admitted to the Intensive Care Unit at Mediheal Hospital for three days after he developed breathing difficulties, poor eyesight and swollen limbs due to the condition.

His mother Jane Wanjugu tells us that her son’s condition was discovered in March 2018, when he was 7-years-old following a misdiagnosis that he had a ‘cold’ that would simply not go away.

It was not until they were referred to Kenyatta National Hospital, where he was diagnosed with rheumatic heart disease.

“After a series of tests, the doctors discovered he had rheumatic heart disease. After the diagnosis, the doctors prescribed medication for Gathura to help him manage the condition. It was difficult for me to hear this from the doctors and I was also shocked, when they told me I would need to bring him for a penicillin jab every month,” she says.

Patients who have contracted rheumatic fever and rheumatic heart disease are required to take this monthly injection of benzathine penicillin in order to prevent further infections.

 Wanjugu says the high costs of managing his son’s condition adds to distress, hardships, and burdens the family is facing as the mitumba business they are depending on is currently making low returns due to stiff competition.

“He takes  Aldactone which costs Sh250 per packet, Enaril which costs Sh20, twice a day; Warfarin which costs Sh100, once  a day; Carnedilol which costs Sh100 twice a day, and Furosemide, once a day. In total, we spend around Sh3,000 on medication every week,” she says. These drugs, however, only manage the condition temporarily.

Dr. Sunir Kumar Dube a cardiologist at Mediheal Hospital referred Gathura to Kenyatta National Hospital for open heart surgery.

“The patient needs to undergo an open-heart surgery to replace the mitral valve and for the repair of the tricuspid valve. The operation costs between Sh1.5 million and 1.6 million,” the cardiologist outlines in his diagnostic report.

He should have had the operation in March, but has been prevented by financial constraints. But Wanjugu will not give up the fight for her son’s life just yet.

“It is my humble appeal to well-wishers to assist my son in the fight to overcome this disease as we are facing steep financial challenges. I know he is one month late, but if we get assistance towards offsetting medical costs and the operation is done, Gathura will still be around for a long time to see his children grow into adults,” she adds.

According to Dr. Dube, rheumatic heart disease is an inflammatory ailment caused by an autoimmune response to a throat infection caused by a group of bacteria called A streptococcus or strep bacteria. The bacteria can cause many illnesses, including sore throat (strep throat) and skin sores.

When the body’s immune system gets confused as it reacts to the bacterial infection, the result is a generalized inflammatory illness that doctors call acute rheumatic fever. It can affect connective tissue throughout the body, especially in the heart, joints, brain and skin.

Dr. Dube explains that although rheumatic fever can strike people of all ages, it is most common in children aged between five and 15 years. The best way to prevent rheumatic fever is to treat strep throat with antibiotics.

This damage to the heart valves is known as rheumatic heart disease. Recurrent strep infections and episodes of acute rheumatic fever cause further damage to heart valves.

The damaged heart valves narrow resulting in decreased blood flow or they may leak causing blood to flow in the wrong direction. Heart muscles could also be damaged, resulting in poor pumping function, or heart failure.

“Children between the ages five to 15 are most susceptible to it and every recurring sore throat further affects the heart valves such that by the time they are in their 20s and 30s, these valves have been seriously or permanently damaged,” explains the cardiologist.

Gathura’s father Cyrus Kabue is getting concerned because the youngster has been very sick for the last three months. The combination of his illness and the strong medications he is taking has caused him to lose a lot of weight.

“He is now but a shell of his old self. The viscosity of the injectable drug is also very high, which makes it very painful yet sometimes he has to be injected more than once just to get the medicine through the veins,” he says.

The family is now calling on well-wishers to help them raise funds for the medical bill, and they can be reached through Pay bill number 247247, Equity Till number 0794249774.

Gathura has so far been sitting quietly listening to the conversation and he tells us in a barely audible voice how having the illnesses has hampered his life.

“I cannot play or run like other children my age. On many occasions, I stay home because I'm too sick to attend school,” he says before leaning his back on a wall, too tired to speak anymore.

In Kenya, medics say the most common types of cardiovascular diseases are ischemic heart disease, which is caused by narrowing of the coronary arteries, decreasing blood supply to the heart and rheumatic heart disease, which is caused by damage to the heart valves. 

According to Dr. Mzee Ngunga, a cardiologist at Aga Khan Hospital, ischemic heart disease is found mostly among the affluent, while the latter appears most prevalent in low-income populations.

“We attribute ischemic heart disease to consumption of a high cholesterol diet and the majority of patients suffering from this condition are Asians and Somalis aged between 50 and 60 years,” he says.

Courtesy K.N.A