Burden of heart diseases in children attending cardiology clinic in a regional referral hospital in Uganda

Abstract

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 20months. All children from birth up to 12years 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 28months (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.