The The Prevalence and Pattern of Cardiac Disease Amongst the Pediatric Age Group in Liberia: A Five-Year Retrospective Cohort Study at the John F. Kennedy Medical Center
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Abstract
Background: Cardiac disease is a huge public health problem for developing countries. Access to healthcare and diagnostic technologies are known to impact the reported prevalence of heart diseases globally.
Objective: The objective of the research is to determine the number and patten of heart diseases amongst the pediatric age group in Liberia and set a platform for investment in cardiac surgery.
Methods: We conducted a five-year retrospective study at the John F. Kennedy Medical Center to determine the prevalence of cardiac disease in Liberia. A total of 175 patients were enrolled. Data were analyzed using Excel 2019, Epi Info version 3.5.3 and SPSS V.27
Results: The prevalence of cardiac disease was 7.6 per 1000 live birth. Male to female ratio was 1:1.5. 40.5% of children were diagnosed during toddler and early adolescent while 56.6% were diagnosed during infancy and 2.9% during the neonatal period. Commonest pathologies were ventricular septal defect, acquired heart disease, patent ductus arteriosus and tetralogy of fallot. Diagnosis was made mainly by history and physical evaluation. Easily fatiguability, dyspnea and murmur were the commonest sign/symptoms. Down syndrome was the most common associated anomalies. 87.4% of children had no surgical treatment and the status of 72.6% were unknown.
Conclusion: Pediatric cardiac diseases is one of the neglected non-communicable clinical diseases in Liberia with a prevalence of 7.6 per 1000 live birth. An estimated 41,600 children are living with cardiac disease in Liberia with over 87% not having any chance of receiving surgical treatment while a very few are being flown out of the country for treatment. More than 77% of the parents of these children are discouraged from bringing their kids for follow ups as they have grown exhausted from repeated hospital visits without any solution. Also, diagnosis of these conditions is a challenge for doctors in Liberia as many of them have not been trained to make early diagnosis and major diagnosis tools are relatively absent as there is only one cardiothoracic surgeon and one cardiology in the country. Ventricular septal defect, acquired heart disease, patent ductus arteriosus and tetralogy of fallot were among the commonest presenting pediatric cardiac disease.
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References
2. Hoffman JIE, Kaplan S. The incidence of congenital heart disease. Journal of the American College of Cardiology. 2002;39(12):1890-1900. doi:10.1016/S0735-1097(02)01886-7
3. van der Linde D, Konings EEM, Slager MA, et al. Birth prevalence of congenital heart disease worldwide: A systematic review and meta-analysis. Journal of the American College of Cardiology. 2011;58(21):2241-2247. doi:10.1016/J.JACC.2011.08.025
4. Qu Y, Liu X, Zhuang J, et al. Incidence of congenital heart disease: The 9-year experience of the Guangdong registry of congenital heart disease, China. PLoS ONE. 2016;11(7). doi:10.1371/journal.pone.0159257
5. Watkins DA, Johnson CO, Colquhoun SM, et al. Global, Regional, and National Burden of Rheumatic Heart Disease, 1990–2015. New England Journal of Medicine. 2017;377(8):713-722. doi:10.1056/NEJMOA1603693
6. Mocumbi AO, Lameira E, Yaksh A, Paul L, Ferreira MB, Sidi D. Challenges on the management of congenital heart disease in developing countries. International Journal of Cardiology. 2011;148(3):285-288. doi:10.1016/J.IJCARD.2009.11.006
7. Nkoke C, Lekoubou A, Dzudie A, et al. Echocardiographic pattern of rheumatic valvular disease in a contemporary sub-Saharan African pediatric population: An audit of a major cardiac ultrasound unit in Yaounde, Cameroon. BMC Pediatrics. 2016;16(1). doi:10.1186/s12887-016-0584-z
8. Beaton A, Okello E, Lwabi P, Mondo C, McCarter R, Sable C. Echocardiography screening for rheumatic heart disease in ugandan schoolchildren. Circulation. 2012;125(25):3127-3132. doi:10.1161/CIRCULATIONAHA.112.092312
9. Marijon E, Ou P, Celermajer DS, et al. Prevalence of Rheumatic Heart Disease Detected by Echocardiographic Screening. New England Journal of Medicine. 2007;357(5):470-476. doi:10.1056/nejmoa065085
10. Oumar BH, Kéita MA, Thiam DC, et al. Prevalence, Pattern and Evolution of Rheumatic Heart Disease: About 120 Cases at Mother-Children University Hospital Luxembourg (MC UHL), Bamako (Mali). World Journal of Cardiovascular Diseases. 2018;08(07):319-327. doi:10.4236/WJCD.2018.87031
11. CDC. Data and Statistics on Congenital Heart Defects.; 2020.
12. Belay W, Aliyu MH. Rheumatic heart disease is missing from the global health agenda. Annals of Global Health. 2021;87(1). doi:10.5334/AOGH.3426/
13. Bemstein D. The cardiovascular system. In Behrman, Kliegman, Jenson Nelson textbook of pediatrics 17th ed, Saunders company; Philadelphia, USA, 2002: 1499-15. Google Search. Accessed January 29, 2022.
14. Braunwald E. Approach to the Patient with Cardiovascular Disease. In: Kasper DL, Braunwald E, Fauci AS, Kauser SL, Lango DL and Jameson JL eds. Hrrison’s principles of Internal Medicine 16 ed, McGraw-Hill medical publishing division New York, USA, 2005: 1301. - Google Search. Accessed January 29, 2022.
15. Chinawa AT, Chinawa JM. Compendium of cardiac diseases among children presenting in tertiary institutions in southern Nigeria: a rising trend. Libyan Journal of Medicine. 2021;16(1). doi:10.1080/19932820.2021.1966217
16. Dolk H, Loane M, Garne E. Congenital heart defects in Europe: Prevalence and perinatal mortality, 2000 to 2005. Circulation. 2011;123(8):841-849. doi:10.1161/CIRCULATIONAHA.110.958405
17. Zhao QM, Liu F, Wu L, Ma XJ, Niu C, Huang GY. Prevalence of Congenital Heart Disease at Live Birth in China. Journal of Pediatrics. 2019;204:53-58. doi:10.1016/J.JPEDS.2018.08.040
18. Zuechner A, Mhada T, Majani NG, Sharau GG, Mahalu W, Freund MW. Spectrum of heart diseases in children presenting to a paediatric cardiac echocardiography clinic in the Lake Zone of Tanzania: A 7 years overview. BMC Cardiovascular Disorders. 2019;19(1). doi:10.1186/S12872-019-01292-4
19. Al-Fahham MM, Ali YA. Pattern of congenital heart disease among Egyptian children: a 3-year retrospective study. Egyptian Heart Journal. 2021;73(1). doi:10.1186/S43044-021-00133-0