Congenital Heart Disease in East Africa

Jivanji, Salim; Lubega, Sulaiman; Reel, Bhupi; Qureshi, Shakeel

doi:10.3389/fped.2019.00250

Cited by 24 publications

(29 citation statements)

References 20 publications

(21 reference statements)

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“…The possibility that this low prevalence of VSD in East Africa might be the absence of a complete diagnosis of VSD due to inadequate structured perinatal diagnostic capabilities that potentially leading to a low detection rate. This is also reflected by the paucity of data in the region and the presence of a large pool of older children and adults debilitated with CHD in sub-Saharan Africa [ 8 ]. Reversely, developed countries have well-structured perinatal diagnostic facilities that can be diagnosed with a higher number of VSD.…”

Section: Discussionmentioning

confidence: 99%

“…However, they have little or no access to treatment of any kind. About half of cases deceased within a few years of birth and one-third of them within the first month of life [ 7 , 8 ]. Additionally, a major proportion of older children and adults with CHD in sub-Saharan Africa survived for longer times are debilitated and live in under chronic illness [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of congenital septal defects among congenital heart defect patients in East Africa: A systematic review and meta-analysis

2021

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Introduction Congenital heart defects (CHDs) are the most common congenital defects and accounts for nearly one-third of all major congenital anomalies. It is the leading causes of birth defect-associated morbidity, mortality, and medical expenditures. Of all CHD types, ventricular septal defect (VSD) and atrial septal defect (ASD) accounted 51% of cases with an increasing trend over time. Objective The aim of this review is to estimate the pooled prevalence of ventricular septal defect and congenital atrial septal defect among congenital heart diseases patients in East African context. Methods Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence of Ventricular septal defect and atrial septal defect in East Africa, from Medline (PubMed), Cochrane Library, HINARI, and Google Scholar. A weighted inverse variance random-effects model was used to estimate the pooled prevalence of ventricular septal defect and atrial septal defect. Results A total of 2323 studies were identified; 1301 from PubMed, 12 from Cochrane Library, 1010 from Google Scholar and 22 from other sources. The pooled prevalence of ventricular septal defect and atrial septal defect in East Africa was found to be 29.92% (95% CI; 26.12–33.72; I2 = 89.2%; p<0.001), and 10.36% (95% CI; 8.05–12.68; I2 = 89.5%; p<0.001) respectively. Conclusions and future implications Based on this review, the pooled prevalence of VSD and ASD is still high and alarming; this signifies that the emphasis given for congenital heart defect in East African countries is limited. Special attention and efforts should be applied for early detection to prevent serious complications and for a better prognosis of all forms of CHD. A screening program for CHD should be instituted during the perinatal period. Furthermore, early referral of suspected cases of congenital cardiac anomalies is mandatory for better management till the establishment of cardiac centers in different regions of the continent.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of congenital septal defects among congenital heart defect patients in East Africa: A systematic review and meta-analysis

2021

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“…Several studies on global birth prevalence of CHD have included some assessment of the birth prevalence in LMIC. An estimated 500,000 children are born with CHD each year in Africa, 240,000 in India, and 150,000 in China (Jivanji, Lubega, Reel, & Qureshi, ; Saxena, ). A recently published comprehensive review of 260 studies included 27 anatomic subtypes of CHD, from 1970 to 2017, and encompassed over 130 million live births (Liu et al, ).…”

Section: Prevalencementioning

confidence: 99%

“…Several studies on global birth prevalence of CHD have included some assessment of the birth prevalence in LMIC. An estimated 500,000 children are born with CHD each year in Africa, 240,000 in India, and 150,000 in China (Jivanji, Lubega, Reel, & Qureshi, 2019;Saxena, 2019 Figure 2a and b show allage and age-standardized global prevalence rates of CHD, respectively. All-age prevalence rate estimates for sub-Saharan Africa are very high.…”

Section: Prevalencementioning

confidence: 99%

Congenital heart disease in low‐and‐middle‐income countries: Focus on sub‐Saharan Africa

Zimmerman

Sable

2020

American J of Med Genetics Pt C

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The etiology of congenital heart disease (CHD) is multifactorial. The birth prevalence of CHD is shaped by a wide variety of maternal, fetal, and neonatal risk factors, along with the rates of prenatal diagnosis and terminations of pregnancy, all of which have geographic variability Epidemiology data availability from low‐and‐middle‐income countries (LMIC) on CHD prevalence, morbidity, and mortality are far more limited than from high income countries. Data on specific genetic, environmental, and prenatal risk associated with CHD are almost nonexistent. In this article, we will focus on defining what data are available, genetic risk factors, birth and overall prevalence, morbidity, and the impact of limited access to interventions, both surgery and cardiac catheterizations. We will highlight CHD in sub‐Saharan Africa to detail epidemiology studies in the poorest regions of the world. Existing literature as well as estimates from the Global Burden of Disease Study (http://ghdx.healthdata.org) form the basis for this review. The intersection of poverty, high fertility rates, and limited access to care results in a unique profile of CHD in LMIC. CHD is not a preventable disease (by most standards), so early detection and access are our key interventions to improve the dire outcomes for children in low‐resources settings of the world.

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“…In the African region the prevalence of CHD was estimated at 2.32 per 1000 live births lower than that of other regions of the globe [4]. However this might be an under-estimate, because of low CHD diagnostic capacity, and early death of children with CHD before its diagnosis [5]. In Uganda, recent estimates indicated that approximately 8300 children are born with CHD every A Case-Control Study at Mulago National Referral Hospital (Uganda Heart Institute) year, and over 2000 of these cases are severe enough to necessitate surgical treatment [6].…”

Section: Introductionmentioning

confidence: 97%

Factors Associated with Congenital Heart Diseases among Children in Uganda: A Case-Control Study at Mulago National Referral Hospital (Uganda Heart Institute)

Kapakasi¹,

Mawa²,

Namuyonga³

et al. 2021

CCR

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Congenital Heart Diseases (CHD) are among the leading causes of morbidity and mortality associated with congenital malformations among children. Not knowing the risk profile of CHD among children in Uganda impedes development of effective prevention interventions. In this hospital based unmatched case-control study we examined risk factors for all types of CHD among 179 pair of case and control children aged 0-10 years old at Mulago National Referral Hospital. Odds ratios and their corresponding 95% confidence intervals were calculated using multivariate logistic regression. Low birth weight (adjusted OR: 3.15, 95% CI 1.48 -6.69), high birth order ≥5 th birth order (adjusted OR: 3.69 (1.10 -12.54), maternal febrile illness during pregnancy, maternal and paternal alcohol consumption, and paternal socio-economic status were associated with CHD. Family history of CHD, maternal education level, maternal chronic illness, and paternal education level were not associated with CHD. The results suggest: low birth weight, high birth order, and maternal febrile illness during pregnancy, parental alcohol use and paternal socio-economic status as dominant risk factors for CHD among children. Rigorous implementation of public health policies and strategies targeting prevention of febrile illness during pregnancy, maternal malnutrition, parental alcohol consumption, delivery of high number of children per woman, might be important in reducing the burden of CHD among children in Uganda.

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Congenital Heart Disease in East Africa

Cited by 24 publications

References 20 publications

Prevalence of congenital septal defects among congenital heart defect patients in East Africa: A systematic review and meta-analysis

Prevalence of congenital septal defects among congenital heart defect patients in East Africa: A systematic review and meta-analysis

Congenital heart disease in low‐and‐middle‐income countries: Focus on sub‐Saharan Africa

Factors Associated with Congenital Heart Diseases among Children in Uganda: A Case-Control Study at Mulago National Referral Hospital (Uganda Heart Institute)

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