Audit of availability and distribution of paediatric cardiology services and facilities in Nigeria

Abstract

SummaryBackgroundPaediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. Objective: To evaluate and document the currently available paediatric cardiac services in Nigeria.MethodsIn this questionnaire-based, cross-sectional descriptive study, an audit was undertaken from January 2010 to December 2014, of the personnel and infrastructure, with their distributions according to geopolitical zones of Nigeria.ResultsForty-eight centres participated in the study, with 33 paediatric cardiologists and 31 cardiac surgeons. Echocardiography, electrocardiography and pulse oximetry were available in 45 (93.8%) centres while paediatric intensive care units were in 23 (47.9%). Open-heart surgery was performed in six (12.5%) centres. South-West zone had the majority of centres (20; 41.7%).ConclusionsAvailable paediatric cardiac services in Nigeria are grossly inadequate and poorly distributed. Efforts should be intensified to upgrade existing facilities, establish new and functional centres, and train personnel.

An analysis of Atrioventricular Canal Defect (AVCD) in Children in the Niger Delta Region of Nigeria, West Africa

“…[6,19,23] Over half of the study population are on oral medication for chronic heart failure while awaiting surgery. This is similar to reports by Ekure et al [13] where a high proportion of CHD patients are only on medical therapy for some symptomatic relieve because they cannot access surgery due to lack of facilities in Nigeria. Oral medications given included Tablet Furosemide (1 to 3 mg/kg/day in two divided doses, 12 hourly) and Tablet spironolactone (1 to 2 mg/kg/day in two divided doses 12 hourly).…”

“…On follow up, only a minority of the study population had corrective surgery done -possibly due to the high cost of surgery in oversea centers in India where the patients went, as facilities for complex congenital heart surgeries are lacking in Nigeria. [13] Of these few who had costly surgeries, two-third were non-syndromic, and only two were syndromic patients, possibly suggesting a prejudice against children with Down's Syndrome who have known mental and other challenges. [6,19,23] Over half of the study population are on oral medication for chronic heart failure while awaiting surgery.…”

“…[2,10] Repair during infancy is recommended as this minimizes the risk of premature death or pulmonary vascular obstructive disease. [3,6] Although there abounds literature on CHD in Nigeria, [11][12][13][14] focused report on AVCD and its characteristics in an African population is lacking. This study thus aims to provide an analysis of AVCD in children in the Niger Delta Region of Nigeria, an area marred by environmental pollution; [15][16][17][18] and highlight its features and echocardiographic characteristics.…”

Congenital Heart Defects in Nigerian Children: Preliminary Data From the National Pediatric Cardiac Registry

“…A recent audit found the availability of pediatric cardiology facilities and services in the entire country to be grossly inadequate but highlighted sharp disparities between northern and southern regions with regard to the distribution of these facilities and services. 18 Therefore, there is the need for better access to definitive care, especially in the North of the country which accounted for only 34.6% of patients enrolled but has twice the land area and about the same population as the South. 21,22 The older age at enrollment of cases in the North may further underscore the limited availability of cardiac resources in the northern part of the country compared to the South coupled with the longer distance that needs to be traveled to access care, while the higher poverty level in the northern part of the country further accentuates the limited accessibility of patients to care.…”

Evaluation of renal injury in children with uncorrected CHDs with significant shunt using urinary neutrophil gelatinase-associated lipocalin

“…[4][5][6][7][8] CHDs contribute to childhood morbidity and mortality, especially in the developing countries where facilities for intervention are often unavailable. 9 The majority of children with CHDs often live with their condition for prolonged periods after diagnoses 1,6,10 with attendant complications, such as heart failure, recurrent pneumonia, and renal injury. 11 CHDs are classified into acyanotic CHDs and cyanotic CHDs.…”