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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Challenges on the management of congenital heart disease in developing countries
International Journal of Cardiology, Volume 148, No. 3, Year 2011
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Description
Introduction: While in developed countries prenatal diagnosis is currently used to detect Congenital Heart Disease before (CHD) before birth, in developing countries only a minority of children with CHD is detected and few benefit from surgical treatment. Having created a referral unit for diagnosis and treatment of cardiovascular diseases in a resource-deprived country we designed a study aiming at describing the spectrum and characteristics of CHD and discuss the challenges of its management. Population and methods: We studied retrospectively all patients assisted at a referral unit between 2001 and 2007, collecting epidemiological, clinical, echocardiographic and surgical data from hospital files. Results: We studied 534 patients with median age at diagnosis of 4 years (range 0-79); 296 were females (55.4%). Only 282 (52.8%) patients were diagnosed under the age of two years, and complications were present in 155 (29.0%) at time of diagnosis. We operated 196 patients with mean age of 8 ± 10 years. Only 29 of the 111 complex defects were considered for surgery. The 30-days post-operative mortality was 8/196 (4.0%). The most important post-surgical complications were post pericardectomy syndrome (22). Discussion: A pattern of late presentation accompanied by high rate of complications was found. In resource-deprived settings the approach to the management of CHD emphasizes the treatment of "curable" malformations. Surgery for CHD in these settings must be linked to early detection and a referral system in which general practitioners, pediatricians, obstetricians and cardiologists interact in the design and implementation protocols for diagnosis, management and follow-up of patients. © 2009 Elsevier Ireland Ltd.
Authors & Co-Authors
Mocumbi, Ana Olga H.
Mozambique, Maputo
Instituto do Coracao Maputo
Lameira, Elsa
Mozambique, Maputo
Instituto do Coracao Maputo
Yaksh, Ameeta
Netherlands, Rotterdam
Erasmus Universiteit Rotterdam
Paul, Louis
Mozambique, Maputo
Instituto do Coracao Maputo
Ferreira, Maria Beatriz
Mozambique, Maputo
Instituto do Coracao Maputo
Sidi, Daniel
Mozambique, Maputo
Instituto do Coracao Maputo
France, Paris
Hôpital Necker Enfants Malades
Statistics
Citations: 142
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1016/j.ijcard.2009.11.006
ISSN:
01675273
Research Areas
Health System And Policy
Maternal And Child Health
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study
Participants Gender
Female