African Annals of
Thoracic and Cardiovascular Surgery

OFFICIAL PUBLICATION OF THE AFRICAN ASSOCIATION OF THORACIC AND CARDIO-VASCULAR SURGEONS
  • Abbreviation: Afr. Ann. Thorac. Cardiovasc. Surg.
  • Language: English
  • ISSN: 1994-7461
  • DOI: 10.5897/AATCVS
  • Start Year: 2005
  • Published Articles: 69

Case Report

Current status of the paediatric congenital heart disease management pathway in Kenya

Mark Nelson Awori
  • Mark Nelson Awori
  • Department of Surgery, School of Medicine, University of Nairobi, P. O. Box 19676-00202, Nairobi, Kenya.
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Daniel Ojuka
  • Daniel Ojuka
  • Department of Surgery, School of Medicine, University of Nairobi, P. O. Box 19676-00202, Nairobi, Kenya.
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Diana Marangu
  • Diana Marangu
  • Department of Paediatrics and Child health, School of Medicine, University of Nairobi, P. O. Box 19676-00202, Nairobi, Kenya
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Paul Bannon
  • Paul Bannon
  • Department of Cardiothoracic Surgery, University of Sydney, NSW 2006, Australia
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  •  Received: 11 March 2024
  •  Accepted: 03 April 2024
  •  Published: 31 May 2024

Abstract

The objective of the current study was to assess the current status of the congenital heart disease (CHD) Management Pathway (MP) in the same public hospital in Kenya, following an assessment conducted sixteen years ago that found all phases of the MP to be inadequate. Over the course of one year, patients under 12 years of age with congenital heart disease (CHD) were consecutively recruited from the general pediatric wards at Kenyatta National Hospital (KNH) in Nairobi. All recruited patients required intervention, either through surgery or cardiac catheterization, and were subsequently followed up for one-year post-recruitment. Data collected encompassed the age at which CHD was first suspected, age at diagnosis, age at intervention, and the outcome at the one-year follow-up. Out of the initial 49 patients recruited, 47 were successfully contacted via mobile phone at the one-year mark post-recruitment. The mean ages at which congenital heart disease (CHD) was first suspected and diagnosed were 35.3 weeks (SD +/- 91.1) and 43.4 weeks (SD +/- 97) respectively, with the mean age at intervention being 47.5 weeks (SD +/- 51). Thirty-five percent of all patients underwent surgery, and 96% were successfully followed up. It is possible that over the last 16 years, there has been an improvement in at least two phases of the Management Pathway (MP). However, the proportion of patients receiving surgery has remained unchanged, suggesting a need for future resource allocation to this phase.
 
Key words:  Congenita,l cardiac, pathway, diagnosis, treatment, follow-up