Trends in pediatric echocardiography and the yield for congenital heart disease in a major cardiac referral hospital in Cameroon

Clovis Nkoke, Eric Balti, Alain Menanga, Anastase Dzudie, Alain Lekoubou, Samuel Kingue, Andre Pascal Kengne

Research output: Contribution to journalArticle

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Abstract

Background: Congenital heart disease (CHD) is a common condition in children in Sub-Saharan Africa (SSA), where it is associated with poor outcomes. Diagnosis of CHD in SSA depends essentially on echocardiography, which is available only in few urban referral centers. Our aim was to assess time changes in the pattern of referral for pediatric echocardiography and the subsequent diagnosis of structural CHD in a major SSA city. Methods: All pediatric echocardiography performed between 2004 and 2013 at the echocardiography laboratory of the Yaounde General Hospital were reviewed. The primary indication of the study and the presence of structural CHD were recorded. Results: Between 2004 and 2013, 9,390 echocardiograms were performed and 834 (8.9%) children aged 1 day to 15 years underwent echocardiography at the center, and 227 (27.2%) cases of defnite structural CHD were diagnosed, with 123 (54.2%) in boys. The most frequent indications for echocardiography were heart murmurs (40%) and the suspicion of CHD (37.4%). The commonest CHD was ventricular septal defect (VSD) (30%) with tetralogy of Fallot being the most frequent cyanotic heart lesion (5.3%). The proportion of pediatric echocardiography decreased from 13.3% in 2004-2005 to 6.1% in 2012-2013 (P=0.001) but not in a linear fashion (P=0.072 for linear trend).The diagnosis of structural CHD increased from 25.1% in 2004-2005 to 27.1% in 2012-2013. This increase however was non-signifcant (P=0.523) and did not follow a linear trend (P=0.230). Conclusions: The pattern of referral for pediatric echocardiography at this center has changed over time, but diagnosis of structural CHD has remained the same. Improving access to this diagnostic procedure and subsequent treatment of diagnosed CHD will help improving the outcome of the disease in this setting.

Original languageEnglish (US)
Pages (from-to)40-45
Number of pages6
JournalTranslational Pediatrics
Volume6
Issue number1
DOIs
StatePublished - Jan 1 2017

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Cameroon
Echocardiography
Heart Diseases
Referral and Consultation
Pediatrics
Africa South of the Sahara
Heart Murmurs
Tetralogy of Fallot
Ventricular Heart Septal Defects
General Hospitals

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Nkoke, Clovis ; Balti, Eric ; Menanga, Alain ; Dzudie, Anastase ; Lekoubou, Alain ; Kingue, Samuel ; Kengne, Andre Pascal. / Trends in pediatric echocardiography and the yield for congenital heart disease in a major cardiac referral hospital in Cameroon. In: Translational Pediatrics. 2017 ; Vol. 6, No. 1. pp. 40-45.
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abstract = "Background: Congenital heart disease (CHD) is a common condition in children in Sub-Saharan Africa (SSA), where it is associated with poor outcomes. Diagnosis of CHD in SSA depends essentially on echocardiography, which is available only in few urban referral centers. Our aim was to assess time changes in the pattern of referral for pediatric echocardiography and the subsequent diagnosis of structural CHD in a major SSA city. Methods: All pediatric echocardiography performed between 2004 and 2013 at the echocardiography laboratory of the Yaounde General Hospital were reviewed. The primary indication of the study and the presence of structural CHD were recorded. Results: Between 2004 and 2013, 9,390 echocardiograms were performed and 834 (8.9{\%}) children aged 1 day to 15 years underwent echocardiography at the center, and 227 (27.2{\%}) cases of defnite structural CHD were diagnosed, with 123 (54.2{\%}) in boys. The most frequent indications for echocardiography were heart murmurs (40{\%}) and the suspicion of CHD (37.4{\%}). The commonest CHD was ventricular septal defect (VSD) (30{\%}) with tetralogy of Fallot being the most frequent cyanotic heart lesion (5.3{\%}). The proportion of pediatric echocardiography decreased from 13.3{\%} in 2004-2005 to 6.1{\%} in 2012-2013 (P=0.001) but not in a linear fashion (P=0.072 for linear trend).The diagnosis of structural CHD increased from 25.1{\%} in 2004-2005 to 27.1{\%} in 2012-2013. This increase however was non-signifcant (P=0.523) and did not follow a linear trend (P=0.230). Conclusions: The pattern of referral for pediatric echocardiography at this center has changed over time, but diagnosis of structural CHD has remained the same. Improving access to this diagnostic procedure and subsequent treatment of diagnosed CHD will help improving the outcome of the disease in this setting.",
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Trends in pediatric echocardiography and the yield for congenital heart disease in a major cardiac referral hospital in Cameroon. / Nkoke, Clovis; Balti, Eric; Menanga, Alain; Dzudie, Anastase; Lekoubou, Alain; Kingue, Samuel; Kengne, Andre Pascal.

In: Translational Pediatrics, Vol. 6, No. 1, 01.01.2017, p. 40-45.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Trends in pediatric echocardiography and the yield for congenital heart disease in a major cardiac referral hospital in Cameroon

AU - Nkoke, Clovis

AU - Balti, Eric

AU - Menanga, Alain

AU - Dzudie, Anastase

AU - Lekoubou, Alain

AU - Kingue, Samuel

AU - Kengne, Andre Pascal

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N2 - Background: Congenital heart disease (CHD) is a common condition in children in Sub-Saharan Africa (SSA), where it is associated with poor outcomes. Diagnosis of CHD in SSA depends essentially on echocardiography, which is available only in few urban referral centers. Our aim was to assess time changes in the pattern of referral for pediatric echocardiography and the subsequent diagnosis of structural CHD in a major SSA city. Methods: All pediatric echocardiography performed between 2004 and 2013 at the echocardiography laboratory of the Yaounde General Hospital were reviewed. The primary indication of the study and the presence of structural CHD were recorded. Results: Between 2004 and 2013, 9,390 echocardiograms were performed and 834 (8.9%) children aged 1 day to 15 years underwent echocardiography at the center, and 227 (27.2%) cases of defnite structural CHD were diagnosed, with 123 (54.2%) in boys. The most frequent indications for echocardiography were heart murmurs (40%) and the suspicion of CHD (37.4%). The commonest CHD was ventricular septal defect (VSD) (30%) with tetralogy of Fallot being the most frequent cyanotic heart lesion (5.3%). The proportion of pediatric echocardiography decreased from 13.3% in 2004-2005 to 6.1% in 2012-2013 (P=0.001) but not in a linear fashion (P=0.072 for linear trend).The diagnosis of structural CHD increased from 25.1% in 2004-2005 to 27.1% in 2012-2013. This increase however was non-signifcant (P=0.523) and did not follow a linear trend (P=0.230). Conclusions: The pattern of referral for pediatric echocardiography at this center has changed over time, but diagnosis of structural CHD has remained the same. Improving access to this diagnostic procedure and subsequent treatment of diagnosed CHD will help improving the outcome of the disease in this setting.

AB - Background: Congenital heart disease (CHD) is a common condition in children in Sub-Saharan Africa (SSA), where it is associated with poor outcomes. Diagnosis of CHD in SSA depends essentially on echocardiography, which is available only in few urban referral centers. Our aim was to assess time changes in the pattern of referral for pediatric echocardiography and the subsequent diagnosis of structural CHD in a major SSA city. Methods: All pediatric echocardiography performed between 2004 and 2013 at the echocardiography laboratory of the Yaounde General Hospital were reviewed. The primary indication of the study and the presence of structural CHD were recorded. Results: Between 2004 and 2013, 9,390 echocardiograms were performed and 834 (8.9%) children aged 1 day to 15 years underwent echocardiography at the center, and 227 (27.2%) cases of defnite structural CHD were diagnosed, with 123 (54.2%) in boys. The most frequent indications for echocardiography were heart murmurs (40%) and the suspicion of CHD (37.4%). The commonest CHD was ventricular septal defect (VSD) (30%) with tetralogy of Fallot being the most frequent cyanotic heart lesion (5.3%). The proportion of pediatric echocardiography decreased from 13.3% in 2004-2005 to 6.1% in 2012-2013 (P=0.001) but not in a linear fashion (P=0.072 for linear trend).The diagnosis of structural CHD increased from 25.1% in 2004-2005 to 27.1% in 2012-2013. This increase however was non-signifcant (P=0.523) and did not follow a linear trend (P=0.230). Conclusions: The pattern of referral for pediatric echocardiography at this center has changed over time, but diagnosis of structural CHD has remained the same. Improving access to this diagnostic procedure and subsequent treatment of diagnosed CHD will help improving the outcome of the disease in this setting.

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