DAR ES SALAAM: LOOLING calm and relaxed, Baraka Samson walked to lane 4 as he and the other six runners from Class V lined for the 100m race at Filbert Bayi School ground during the recently staged Inter-class Athletic Competition at Mkuza, Kibaha in the Coast Region.
Aged 12 years, Baraka looked a favourite to win the race since he has won it many times.
On your marks, the starter said loudly, then get ready, go!
Baraka was not quick enough at the start, but he held his breath and increased speed in the last 20m sprint. He crossed the line first, and later he fell down on the track.
Sports teachers rushed to him and carried him away to the dispensary.
After a first aid treatment, he said he felt dizzy before he fainted.
A report from the medical experts warned the school authority that Baraka had heart complications, but he can still play sports and participate in activities on some level despite his heart condition.
Hearing Baraka had heart complications baffled his parents and his classmates alike.
Heart complications may look alien to the youth, as it is mostly associated with senior people aged above 65 years
Unknown to most Tanzanians, heart disease among children is increasingly coming into focus in Tanzania not necessarily because it is becoming more common, but because advances in medical technology, improved specialist training and better diagnostic capacity are making it easier to detect conditions that previously went unnoticed.
Health experts say many heart conditions existed for decades but were rarely identified due to limited screening tools and specialised services.
Today, early diagnosis is helping to reveal the true scale of the problem.
Globally, medical data shows that about one to two out of every 100 babies are born with some form of congenital heart defect, structural abnormalities present at birth, such as holes in the heart, valve malformations or other functional defects.
Applying these global estimates locally, Tanzania, which records close to two million live births annually, may see more than 10,000 babies born each year with heart abnormalities.
These conditions vary widely in severity. Some are mild and may resolve naturally as a child grows, requiring only monitoring. Others demand medical intervention, including corrective surgery.
According to a Consultant Pediatric Cardiologist and Director of Clinical Support Services at the Jakaya Kikwete Cardiac Institute (JKCI), Dr Nice Majani, the most severe cases require surgery within the first year of life where delays beyond that window can significantly reduce survival chances or lead to permanent complications.
In recent talks with the media outlets, Dr Majani said the estimates show that about 4,000 Tanzanian children annually require heart surgery due to congenital conditions alone, a figure that underscores the scale of demand for specialised paediatric cardiac care.
However, she further said that congenital heart disease is only part of the story as another major concern affecting children and adolescents is rheumatic heart disease, an acquired condition linked primarily to untreated throat infections such as tonsillitis caused by streptococcal bacteria.
“Unlike congenital defects, children with rheumatic heart disease are usually born healthy but develop complications later, often between ages five and 19,” the Dr said.
According to Dr Majani, the condition begins with a seemingly simple sore throat or tonsillitis. If not properly treated, the body’s immune response can trigger rheumatic fever, an inflammatory disease that damages heart valves over time. Because early symptoms can be mild or absent, many children continue attending school normally while silent heart damage progresses.
Additionally, Dr Majani noted that recent screening exercises highlight the hidden nature of the disease, as a survey conducted among approximately 1,600 schoolchildren in Shinyanga and Singida regions found nearly 50 children showing early signs of rheumatic heart disease despite appearing outwardly healthy.
More concerning, 35 of them already had established heart damage.
These findings suggest that many cases remain undetected until complications become severe.
Moreover, she attributed childhood heart disease to multiple factors, noting that for congenital conditions, risks often arise during the first trimester of pregnancy when the baby’s organs are forming.
She mentioned poor maternal nutrition, particularly lack of folic acid, to be associated with a higher risk of congenital abnormalities, while other factors include alcohol consumption, smoking, unregulated medication use during pregnancy, and untreated maternal infections/diseases can also contribute.
However, the Dr said that despite decades of research, the exact cause of most congenital heart defects remains unknown,n stating that only about 20 per cent of cases can be clearly linked to identifiable factors such as infections, environmental exposures or genetics.
She said that the remaining 80 percent occur without a clear explanation, though hereditary patterns have been observed in some families.
On a broader scale, cardiovascular diseases remain the leading cause of death worldwide.
According to the World Health Organisation (WHO), about 19.8 million people died from cardiovascular diseases in 2022, representing roughly one-third of all global deaths.
More than three-quarters of these deaths occur in low- and middle-income countries, including many in Africa. While most fatalities occur in adults, childhood heart conditions contribute to long-term health burdens that can extend into adulthood if not properly managed.
Many cardiovascular diseases are preventable through addressing behavioural and environmental risk factors such as tobacco use, unhealthy diets high in salt, sugar and fat, physical inactivity, obesity, harmful alcohol use and air pollution.
For children, prevention also includes early treatment of infections, improved maternal health care, proper nutrition and access to regular medical screening.
Symptoms of heart disease in children can vary. Some may experience poor growth, fatigue, breathing difficulties, bluish skin discolouration or recurrent infections. In rheumatic heart disease, symptoms may include shortness of breath, chest pain, irregular heartbeats, fatigue or fainting.
However, some children remain asymptomatic for years, making routine screening particularly important.
Health experts emphasise that early detection remains the most effective way to improve outcomes.
When identified early, many heart conditions can be managed through medication, lifestyle adjustments or surgery, allowing children to live full and productive lives. Delayed diagnosis, however, often leads to complications that are more difficult and costly to treat.
In Tanzania, efforts are gradually expanding to strengthen paediatric cardiac services, raise public awareness and improve access to specialised care.
Still, challenges remain, including limited surgical capacity, uneven access to diagnostic services and public awareness gaps about early symptoms and prevention.
Ultimately, experts stress that tackling childhood heart disease requires a coordinated approach — improved maternal health, early childhood screening, timely treatment of infections, public education and investment in specialised health services. As diagnostic capacity continues to improve, the hope is not only to detect more cases early but also to reduce the long-term impact of heart disease on Tanzania’s youngest generation.