Congenital Heart Defects in Nigerian Children: Preliminary Data From the National Pediatric Cardiac Registry
Congenital Heart Defects in Nigerian Children: Preliminary Data From the National Pediatric Cardiac Registry
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DOI：
10.1177/2150135117725457
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发表时间：
2017-11-01
影响因子：
0.9
通讯作者：
Ogunkunle, Oluwatoyin O.
中科院分区：
文献类型：
--
作者：
Ekure, Ekanem N.;Bode-Thomas, Fidelia;Ogunkunle, Oluwatoyin O.
背景：先天性心脏病（CHD）是常见的出生缺陷，对发病率和死亡率有重大影响。我们旨在采用基于登记的方法比较尼日利亚先心病的区域模式。方法：2014 年 1 月至 12 月期间，全国 17 个医疗中心经超声心动图确诊患有先心病的儿童被纳入国家儿科心脏登记试点。结果：共有 1,296 名先心病儿童（52.9% 为男性；中位年龄 0.9 岁）入组。尼日利亚北部入组的患者占研究人群的 34.6%，并且与尼日利亚南部入组的患者相比年龄更大（2.9 ± 3.6 岁 vs 2.4 +/- 3.5 岁；P = .02）。与南方（18.5%；P < .0001）相比，北方（37.4%）室间隔缺损的发生率明显更高，而南方严重的 CHD 更为常见（P = .004）。在接受矫正性心脏干预的 208 名儿童（16.0%）中，只有 43 名（20.7%）在乡村进行了干预。与北方相比，南方更多的患者接受了干预（19.02% vs 10.5%；P < .0001）。 结论：这是第一项针对尼日利亚儿童 CHD 的前瞻性、基于登记的多中心研究。我们证明了该国北部和南部地理区域在诊断年龄、病变类型和严重程度以及接受心脏手术的机会方面存在重要差异。研究结果证明了国家冠心病登记对于了解低收入和中等收入国家冠心病临床流行病学的效用及其作为研究和规划基础的潜力。
Background: Congenital heart defects (CHDs) are common birth defects with significant impact on morbidity and mortality. We aimed to compare regional patterns of CHDs in Nigeria using a registry-based approach.Methods: Children with echocardiography-confirmed CHDs at 17 medical centers across the country were enrolled in a pilot National Pediatric Cardiac Registry from January to December 2014.Results: A total of 1,296 children (52.9% male; median age 0.9 years) with CHDs were enrolled. Patients enrolled in Northern Nigeria constituted 34.6% of the study population and were older compared to those enrolled from Southern Nigeria (2.9 3.6 vs 2.4 +/- 3.5 years; P = .02). Ventricular septal defects were significantly more prevalent in the North (37.4%) compared with the South (18.5%; P < .0001), while severe CHDs were more prevalent in the South (P = .004). Of the 208 (16.0%) children who received corrective cardiac intervention, only 43 (20.7%) of them had the intervention done in country. More patients in the South received intervention compared to the North (19.02% vs 10.5%; P < .0001).Conclusion: This is the first prospective, registry-based, multicenter study of CHDs in Nigerian children. We demonstrate important differences between the Northern and the Southern geographical regions of the country in terms of age at diagnosis, type, and severity of lesion as well as access to cardiac surgery. The findings demonstrate the utility of a national CHDs registry for understanding clinical epidemiology of CHDs in low- and middle-income countries and its potential to serve as a basis for research and planning.