Enhancing Quality of Congenital Heart Care Within Resource-Limited Settings

Mohsin, Shazia; Hasan, Babar; Zheleva, Bistra; Kumar, Raman Krishna

doi:10.1007/s00246-023-03351-2

Cited by 2 publications

(2 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Collaborating with specialised cardiac centres and establishing clear referral pathways can ensure timely diagnosis and treatment ( 20 21 ). Subsequently, implementing quality assurance programs to monitor and evaluate the performance of PHWs will help improve their diagnostic skills ( 19 73 ). Where feasible, exploring intelligent auscultation and using clinical scores can improve referrals and prevent overcrowding; indeed, implementing intelligent auscultation in resource-limited settings has been an area of active research in recent years ( 68 69 70 71 72 ).…”

Section: Discussionmentioning

confidence: 99%

“…Again, Africa faces a significant challenge, with the highest rate of unrepaired CHD cases; it is estimated that only 3% of children needing heart surgery in the continent receive it ( 9 10 31 ). The region’s limited access to specialised care, insufficient treatment facilities, and inadequate attention to cardiac illnesses in children are the primary reasons for this disparity ( 14 15 16 17 18 19 20 21 ). These regional inequalities in diagnosis and treatment extend to other paediatric heart conditions, including RHD ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spectrum of Heart Diseases in Children in a National Cardiac Referral Center Tanzania, Eastern Africa: A Six-Year Overview

Majani,

Koster,

Kalezi

et al. 2024

Global Heart

View full text Add to dashboard Cite

Background: While communicable diseases have long been the primary focus of healthcare in Africa, the rising impact of paediatric and congenital heart disease (CHD) cannot be overlooked. This research aimed to estimate the frequency and pattern of heart diseases in children who underwent their first echocardiography at a national cardiac referral hospital in Tanzania. Methods: A retrospective observational study was conducted on children aged 0 to 18 years referred for first-time cardiological evaluation from January 2017 to December 2022. Retrieval of social and echocardiogram data and descriptive analysis were performed. Results: There were 6,058 children with complete reports. Of these, 52.8% (3,198) had heart disease, of whom 2,559 (80%) had CHD, while (340/639; 53.2%) with acquired heart disease (AHD) had rheumatic heart disease (RHD). Children with CHD had a median age 1.0 years (IQR: 0.3–3.5) and were predominantly 51.2% male. Children with RHD had a median age 9.7 years (IQR: 3.2–13.8) with equal gender distribution. Shunt lesions were common in 1,487 (58.1%), mainly VSD 19.3%, PDA 19.1%, ASD 15.1%, and atrioventricular septal defect (AVSD) 4.6%. Pulmonary valve stenosis was in 97 (3.8%). Around 35% (718) had cyanotic CHD, with TOF being most common (13.3%), followed by double outlet right ventricle (DORV) (3.6%). Compared to global average truncus arteriosus was higher in 69 (2.3%) children. In contrast, TGA and hypoplastic left heart syndrome (HLHS) were lower than the estimated global average seen in 2.3% and 0.5% of the cases, respectively. Atresia of the right-side valves was more common (174 vs. 24), and approximately 40% of the patients referred for first-time echocardiographic evaluation required hospitalization. Conclusion: Congenital heart disease is the primary cause of heart disease in children presenting at a national referral hospital, surpassing RHD. With its distinct distribution pattern, acyanotic lesions are more frequent than cyanotic heart diseases. The observed late referral tendencies suggest improving the referral system, enhancing CHD awareness among healthcare professionals, and instituting nationwide screening programs.

show abstract