虽然传染病长期以来一直是非洲医疗保健的主要焦点,儿科和先天性心脏病(CHD)的影响越来越大,不容忽视。这项研究旨在评估在坦桑尼亚国家心脏转诊医院接受首次超声心动图检查的儿童的心脏病频率和模式。
■对2017年1月至2022年12月首次接受心脏评估的0至18岁儿童进行了回顾性观察性研究。检索社会和超声心动图数据并进行描述性分析。
■有6058名儿童有完整的报告。其中,52.8%(3,198人)患有心脏病,其中2559人(80%)患有冠心病,(340/639;53.2%)后天性心脏病(AHD)患者有风湿性心脏病(RHD)。CHD儿童的中位年龄为1.0岁(IQR:0.3-3.5),男性占51.2%。RHD儿童的平均年龄为9.7岁(IQR:3.2-13.8),性别分布相同。分流病变常见于1,487例(58.1%),主要是VSD19.3%,PDA19.1%,ASD15.1%,和房室间隔缺损(AVSD)4.6%。肺动脉瓣狭窄97例(3.8%)。约35%(718)患有紫红色CHD,TOF最常见(13.3%),其次是右心室双出口(DORV)(3.6%)。与全球平均动脉干相比,69(2.3%)儿童的动脉干更高。相比之下,TGA和左心发育不良综合征(HLHS)低于2.3%和0.5%病例的估计全球平均水平,分别。右侧瓣膜的闭锁更为常见(174vs.24),约40%的首次超声心动图评估患者需要住院治疗.
先天性心脏病是在国家转诊医院就诊的儿童心脏病的主要原因,超越RHD。凭借其独特的分布模式,紫花苜蓿病变比紫花苜蓿性心脏病更常见。观察到的延迟转诊趋势表明改善转诊系统,提高医疗保健专业人员对冠心病的认识,并建立全国性的筛查计划。
UNASSIGNED: While communicable diseases have long been the primary focus of healthcare in Africa, the rising impact of paediatric and congenital heart disease (CHD) cannot be overlooked. This research aimed to estimate the frequency and pattern of heart diseases in children who underwent their first echocardiography at a national cardiac referral hospital in Tanzania.
UNASSIGNED: A retrospective observational study was conducted on children aged 0 to 18 years referred for first-time cardiological evaluation from January 2017 to December 2022. Retrieval of social and echocardiogram data and descriptive analysis were performed.
UNASSIGNED: There were 6,058 children with complete reports. Of these, 52.8% (3,198) had heart disease, of whom 2,559 (80%) had CHD, while (340/639; 53.2%) with acquired heart disease (AHD) had rheumatic heart disease (RHD). Children with CHD had a median age 1.0 years (IQR: 0.3-3.5) and were predominantly 51.2% male. Children with RHD had a median age 9.7 years (IQR: 3.2-13.8) with equal gender distribution. Shunt lesions were common in 1,487 (58.1%), mainly VSD 19.3%, PDA 19.1%, ASD 15.1%, and atrioventricular septal defect (AVSD) 4.6%. Pulmonary valve stenosis was in 97 (3.8%). Around 35% (718) had cyanotic CHD, with TOF being most common (13.3%), followed by double outlet right ventricle (DORV) (3.6%). Compared to global average truncus arteriosus was higher in 69 (2.3%) children. In contrast, TGA and hypoplastic left heart syndrome (HLHS) were lower than the estimated global average seen in 2.3% and 0.5% of the cases, respectively. Atresia of the right-side valves was more common (174 vs. 24), and approximately 40% of the patients referred for first-time echocardiographic evaluation required hospitalization.
UNASSIGNED: Congenital heart disease is the primary cause of heart disease in children presenting at a national referral hospital, surpassing RHD. With its distinct distribution pattern, acyanotic lesions are more frequent than cyanotic heart diseases. The observed late referral tendencies suggest improving the referral system, enhancing CHD awareness among healthcare professionals, and instituting nationwide screening programs.