Improving Pediatric Cardiac Surgical Care in Developing Countries: Matching Resources to Needs

Dearani, Joseph A.; Neirotti, Rodolfo A.; Kohnke, Emily J.; Sinha, Krishnendu; Cabalka, Allison K.; Barnes, Roxann D.; Jacobs, Jeffrey P.; Stellin, Giovanni; Tchervenkov, Christo I.; Cushing, John C.

doi:10.1053/j.pcsu.2010.02.001

Cited by 75 publications

(90 citation statements)

References 11 publications

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“…It is not only the lack of surgeons, lack of pediatric cardiologists, specialist nurses and all other professionals. In a complex system such as pediatric cardiac surgery, the surgical outcome depends not only on technical factors, but it is the result of organizational, personal facts and their interactions [3].…”

Section: Rodolfo Neirottimentioning

confidence: 99%

Cirurgia cardiovascular pediátrica: aquilo devemos preservar, o que devemos melhorar e o que devemos transformar

Canêo¹

2012

Rev Bras Cir Cardiovasc

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Section: Rodolfo Neirottimentioning

confidence: 99%

Cirurgia cardiovascular pediátrica: aquilo devemos preservar, o que devemos melhorar e o que devemos transformar

Canêo¹

2012

Rev Bras Cir Cardiovasc

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“…The absence of early diagnosis, surgical intervention and inadequate access to medication coupled with the existing burden of communicable diseases increases the strain on a staggering economy of most sub Saharan countries [4]. Unlike in the developed countries, children with heart disease in LMIC present late with severe complications to hospitals that are inadequately equipped to manage both the simple and complex heart diseases [5][6][7][8]. Over the years, good will organizations have come to aid in providing surgical intervention for the children with heart diseases within and out of their countries [2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Burden of Heart Diseases in Children Attending Cardiology Clinic in a Regional Referral Hospital in Uganda

Nampijja

Kumbakumba

Bajunirwe

et al. 2017

ICPJL

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Introduction: Patterns and prevalence of heart diseases are different between the high income countries and low income countries. Acquired heart diseases like RHD, cardiomyopathies, pericarditis are still a public health burden while congenital heart diseases still carry a poor outcome among children. The aim of this study was to report the burden and pattern of heart diseases in a semi urban referral hospital in Uganda. Methods:This was a prospective study in the paediatrics department at a regional referral hospital in south western Uganda over a period of 20 months. All children from birth up to 12 years who were referred or presented at the paediatrics department from different areas in the region for an index cardiac evaluation and had their transthoraxic echo done were included in the study. These children were enrolled and followed up in the cardiology clinic for chronic care. Those who did not turn up for their expected reviews were followed up with phone calls to find out their outcome.Results: Two hundred and forty children were screened during this period and 158 (65.8%) had abnormal echocardiological findings. More females than males were had abnormal Echos at 51.9%. VSD were the commonest acyanotic heart disease followed by PDA at 37% and 17% respectively. TOF has the highest prevalence at 8.23% followed by Truncus arteriosus at 5.9% amongst the cyanotic heart diseases. Mean age at diagnosis of congenital heart disease was 28 months (SD 33). RHD was the commonest acquired heart diseases (72.5%.) Sixty three percent of children needed and were referred to the national cardiac centre. Only 52% of referred children managed to go to the national referral cardiac centre. Of all the children who needed surgical intervention, 4.4% got the intervention. 25% of the children died while 12.7% were lost to follow up. Conclusion;There is a high burden of heart diseases in south western Uganda with limited access to interventional services.

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“…The four most common causes of NCD deaths are cardiovascular diseases (17.5 million), cancer (8.2 million), respiratory diseases (4 million), and diabetes mellitus (1.5 million) [1,2]. Congenital heart disease is present is approximately 1% of live births, thereby making it the most common major congenital abnormality [3]. Every year, approximately 90% of more than one million children born with congenital heart disease around the world receive suboptimal care or have no access to care.…”

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confidence: 99%

“…Innovation is essential for improvements in the health care systemboth product innovation (technologies, devices, and so forth) and process innovation (care pathways, algorithms, protocols, databases, and so forth). Improvements in the sciences need (1) knowledge development that adds value by processing existing information to define and solve problems; (2) cross-fertilization of ideas-networking and physical proximity of well-informed people who have time and resources to review, think, and experiment; (3) strong connections with university and industry; and (4) good governance-particularly with regard to legal protection of innovations [4][5][6].…”

mentioning

confidence: 99%

“…Although all these components seem obvious, the ability to create successful change and develop action plans in the developing world is hampered by many factors. Successful change requires vision, skills, incentives, resources, and an action plan (Fig 1) [3]. The ability to retain skilled providers, and to offer incentives and resources, can be challenging in less privileged areas of the world.…”

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confidence: 99%

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Humanitarian Outreach in Cardiothoracic Surgery: From Setup to Sustainability

Dearani

Jacobs

Bolman

et al. 2016

The Annals of Thoracic Surgery

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Noncommunicable diseases account for 38 million deaths each year, and approximately 75% of these deaths occur in the developing world. The most common causes include cardiovascular diseases, cancer, respiratory diseases, and diabetes mellitus. Many adults with acquired cardiothoracic disease around the world have limited access to health care. In addition, congenital heart disease is present in approximately 1% of live births and is therefore the most common congenital abnormality. More than one million children in the world are born with congenital heart disease each year, and approximately 90% of these children receive suboptimal care or have no access to care. Furthermore, many children affected by noncongenital cardiac conditions also require prevention, diagnosis, and treatment. Medical and surgical volunteerism can help facilitate improvement in cardiothoracic health care in developing countries. As we move into the future, it is essential for physicians and surgeons to be actively involved in political, economic, and social aspects of society to serve health care interests of the underprivileged around the world. Consequently, in developing countries, a critical need exists to establish an increased number of reputable cardiothoracic programs and to enhance many of the programs that already exist. The optimal strategy is usually based on a long-term educational and technical model of support so that as case volumes increase, quality improves and mortality and morbidity decrease. Humanitarian outreach activities should focus on education and sustainability, and surgical tourism should be limited to those countries that will never have the capability to have free-standing cardiothoracic programs.

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Improving Pediatric Cardiac Surgical Care in Developing Countries: Matching Resources to Needs

Cited by 75 publications

References 11 publications

Cirurgia cardiovascular pediátrica: aquilo devemos preservar, o que devemos melhorar e o que devemos transformar

Cirurgia cardiovascular pediátrica: aquilo devemos preservar, o que devemos melhorar e o que devemos transformar

Burden of Heart Diseases in Children Attending Cardiology Clinic in a Regional Referral Hospital in Uganda

Humanitarian Outreach in Cardiothoracic Surgery: From Setup to Sustainability

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