Making cardiac surgery feasible in African countries: Experience from Namibia, Uganda, and Zambia

Forcillo, Jessica; Watkins, David; Brooks, Andre; Hugo-Hamman, Christopher; Chikoya, Laston; Oketcho, Michael; Thourani, Vinod H.; Zühlke, Liesl; Toit, Henning du; Nghaamwa, Jones; Beshir, Simon; Shidhika, Fenny; Mwandileya, Mashaka; Mulendele, Evans; Musuku, John; Okello, Emmy; Mwambu, Tom; Omagino, John; Lwabi, Peter; Nyakoojo, Wilson

doi:10.1016/j.jtcvs.2019.01.054

Cited by 30 publications

(59 citation statements)

References 18 publications

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“…Increasing calls to improve the scale‐up of and access to surgery/interventions in low‐income countries reflect service deficiencies highlighted in studies.…”

Section: Discussionmentioning

confidence: 99%

Standardizing clinical care measures of rheumatic heart disease in pregnancy: A qualitative synthesis

Vaughan

Dawson

Peek

et al. 2019

Birth

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Background Rheumatic heart disease (RHD) is a preventable cardiac condition that escalates risk in pregnancy. Models of care informed by evidence‐based clinical guidelines are essential to optimal health outcomes. There are no published reviews that systematically explore approaches to care provision for pregnant women with RHD and examine reported measures. The review objective was to improve understanding of how attributes of care for these women are reported and how they align with guidelines. Methods A search of 13 databases was supported by hand‐searching. Papers that met inclusion criteria were appraised using CASP/JBI checklists. A content analysis of extracted data from the findings sections of included papers was undertaken, informed by attributes of quality care identified previously from existing guidelines. Results The 43 included studies were predominantly conducted in tertiary care centers of low‐income and middle‐income countries. Cardiac guidelines were referred to in 25 of 43 studies. Poorer outcomes were associated with higher risk scores (detailed in 36 of 41 quantitative studies). Indicators associated with increased risk include anticoagulation during pregnancy (28 of 41 reported) and late booking (gestation documented in 15 of 41 studies). Limited access to cardiac interventions was discussed (19 of 43) in the context of poorer outcomes. Conversely, early assessment and access to regular multidisciplinary care were emphasized in promoting optimal outcomes for women and their babies. Conclusions Despite often complex care requirements in challenging environments, pregnancy provides an opportunity to strengthen health system responses and address whole‐of‐life health for women with RHD. A standard set of core indicators is proposed to more accurately benchmark care pathways, outcomes, and burden.

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“…Increasing calls to improve the scale‐up of and access to surgery/interventions in low‐income countries reflect service deficiencies highlighted in studies.…”

Section: Discussionmentioning

confidence: 99%

Standardizing clinical care measures of rheumatic heart disease in pregnancy: A qualitative synthesis

Vaughan

Dawson

Peek

et al. 2019

Birth

View full text Add to dashboard Cite

show abstract

“…Training teams within the local context has been the core strategy of the program since its start, as a proven cost-effective and sustainable approach to capacity building. 8 During the surgical training program, high-income country (HIC) (e.g. from South Korea) and LMIC teams (e.g.…”

Section: Capacity Buildingmentioning

confidence: 99%

The role of cardiac surgery in global surgery and global health: a case study from Tashkent

Choi

Vervoort

2019

Journal of Global Health Reports

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“…Large disparities in cardiac surgery care were found between neighboring adjacent countries and these locoregional disparities have already been recognized. 3,4 It is impossible to challenge the authors' premise that there are significant worldwide disparities in the care of patients requiring cardiac surgery. It only takes a visit to a hospital in a resource-limited country to understand that patients are dying from totally treatable cardiac diseases.…”

mentioning

confidence: 99%

Commentary: Worldwide disparities in cardiac surgical care: Thinking globally not locally to solve problems of limited resources and access to specialized care

Ferraris

Pezzella²

2020

The Journal of Thoracic and Cardiovascular Surgery

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Making cardiac surgery feasible in African countries: Experience from Namibia, Uganda, and Zambia

Cited by 30 publications

References 18 publications

Standardizing clinical care measures of rheumatic heart disease in pregnancy: A qualitative synthesis

Standardizing clinical care measures of rheumatic heart disease in pregnancy: A qualitative synthesis

The role of cardiac surgery in global surgery and global health: a case study from Tashkent

Commentary: Worldwide disparities in cardiac surgical care: Thinking globally not locally to solve problems of limited resources and access to specialized care

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