Humanitarian Cardiology and Cardiac Surgery in Sub-Saharan Africa

Tefera, Endale; Nega, Berhanu; Yadeta, Dejuma; Chanie, Yilkal

doi:10.1177/2150135116668834

Cited by 22 publications

(26 citation statements)

References 15 publications

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“…This is the most frequently used model and the easiest to use. It is expensive and the local training has been shown to be ineffective and suboptimal for skill transfer ( 9 ), and entirely dependent on donations.…”

Section: Discussionmentioning

confidence: 99%

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The Shisong Cardiac Center in Cameroon: An Example of a Long-Term Collaboration/Cooperation Toward Autonomy

Giamberti

Butera

Mvondo³

et al. 2018

Front. Pediatr.

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Congenital heart diseases (CHD) are present in nearly 1% of live births; according to WHO, there are 1. 5 million newborns affected by CHD per year and more than 4 million children waiting for cardiac surgery treatment worldwide. The majority of these children (~90%) could be treated, saved and subsequently have a good quality of life but unfortunately, in developing countries with a suboptimal care or no access to care, they are destined to die. Cameroon, one of the 40 poorest countries in the world, is a typical example of this dramatic scenario and this is why we started a collaboration project with a local religious partner (Tertiary Sisters of Saint Francis) in 2001 with the aim of establishing the first cardiac surgery center in this country. There are various well-known organizational models to start a cooperation project in pediatric cardiac surgery in a developing country. In our case, the project included a long-term collaboration with a stable local partner, a big financial investment and a long period of development (10 years or more). It is probably the most difficult model but it is the only one with the greatest guarantee of success in terms of sustainability and autonomy. The aim of this study is to analyze the constructive and problematic aspects of the 17-year collaboration in this project, and to assess possible solutions regarding its critical issues. Although much has been done during this 17-year we are aware that there is still a lot that needs to be done.

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Section: Discussionmentioning

confidence: 99%

“…In Cameroon, 45% of the population is under 15 years of age, as expressed in Table 1 the birth rate of Cameroon is 36.2‰ with an infant mortality of 63‰, the life expectancy is 54.8 years for males and 57.1 years for females ( 9 ).…”

Section: Cameroonmentioning

confidence: 99%

The Shisong Cardiac Center in Cameroon: An Example of a Long-Term Collaboration/Cooperation Toward Autonomy

Giamberti

Butera

Mvondo³

et al. 2018

Front. Pediatr.

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“…Data analysis: The collected data were analyzed using descriptive and inferential statistics. Statistical package for social sciences (SPSS) version 22 software was used to analyze the data.Frequencies and percentages were used to present categorical data. Parametric tests were used to assess the association between variables and outcome.…”

Section: Settingmentioning

confidence: 99%

“…Treatment of CHD in most parts of Africa, including Ethiopia, is provided by overseas voluntary mission or humanitarian aid, and the majority of the patients do not have access to the service. Success of such treatment models in sustaining the care has been questioned, and reconsideration was suggested (22,23).Global call for coordination of such pediatric cardiac surgery mission efforts was also recommended (24). Evidence on CHD related SAM is scarce from Africa and absent from Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Severe Acute Malnutrition among Unoperated Ethiopian Children with Congenital Heart Disease: A Wake-up Call to Reverse the Situation, A Retrospective Cross-Sectional Study

Assefa

Tadele

2020

Ethiop J Health Sci

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BACKGROUND፡ Children with Congenital Heart Disease (CHD) are at increased risk for severe acute malnutrition (SAM). We aimed to determine the magnitude and determinants of SAM among children with CHD in a tertiary hospital.METHODS: Retrospective cross-sectional study was conducted among children with CHD between 2016 and 2019. Clinical and anthropometric data were retrieved from medical records. Anthropometric assessment was done by using WHO standard growth curves. Data analysis was done using Statistical Package for Social Sciences V22. Statistical significance was set at p-value<0.05, and multivariable logistic regression was used to determin predictors.RESULTS: There were 2400 pediatric admissions during the study period,CHD accounted for 6.5%(156) of admissions. For review, 141 records were eligible. The gender distribution was comparable, males 51.1% (72). Infants (<12 months) and older children (>12 months) accounted for 57.4% (81) and 42.6% (60) of study subjects, respectively. SAM was documented in 51.8% (73) of the study subjects, [95% CI: 44.7-60.2]. Infants had higher odds of SAM compared to children aged >12 months[adjusted odds ratio (AOR)= 4.48, 95%CI:2.07-9.70]. Anemic children had higher odds for SAM[AOR =3.76, 95% CI:1.54-9.18]. Children without acyanotic CHD with heart failure(HF) were 58% less likely to develop SAM[AOR= 0.42, 95% CI:0.19-0.96].CONCLUSION: The burden of SAM among children with CHD is high. Younger age,anemia and acyanotic CHD with HF predicted SAM.Screening for anemia and targeted anthropometric assessment are recommended for early SAM detection.

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“…However, it is difficult to discern how many of the host units have become self-reliant. This was highlighted in a study of 26 medical missions in sub-Saharan Africa (13). The authors concluded that the current model of collaboration via short term medical missions appears sub optimal for skill transfer and suggested deeper involvement of universities, governmental institutions, and visiting teams.…”

Section: Short Term Medical Missionsmentioning

confidence: 94%

Pediatric Cardiac Surgery in Low-and Middle-Income Countries: Present Status and Need for a Paradigm Shift

2019

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In low and mid-income countries, there has been a 50% global decrease in the incidence of preventable deaths of children since 1990. However, the mortality from non-communicable diseases (NCD) such as congenital heart disease (CHD) has not changed. Of the estimated 1.3 million children born with CHD annually, over 90% do not have access to cardiac care. With the increasing fertility rates in sub-Saharan Africa, the health burden of CHD will increase as well. Over the last 30 years much has been achieved with short term cardiac medical missions. However, much remains to be done to provide long term solutions needed to achieve the sustainable development goal of reducing deaths of children <5 years of age. This review discusses the present status and the need for a paradigm shift to achieve long term sustainability.

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Humanitarian Cardiology and Cardiac Surgery in Sub-Saharan Africa

Abstract: The current model of collaboration has brought cardiac care to patients having cardiac diseases. However, the model appears to be suboptimal for skill transfer. The model needs to be reshaped to achieve this complex goal.

Cited by 22 publications

References 15 publications

The Shisong Cardiac Center in Cameroon: An Example of a Long-Term Collaboration/Cooperation Toward Autonomy

The Shisong Cardiac Center in Cameroon: An Example of a Long-Term Collaboration/Cooperation Toward Autonomy

Severe Acute Malnutrition among Unoperated Ethiopian Children with Congenital Heart Disease: A Wake-up Call to Reverse the Situation, A Retrospective Cross-Sectional Study

Pediatric Cardiac Surgery in Low-and Middle-Income Countries: Present Status and Need for a Paradigm Shift

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