Objectives: The ‘Management Pathway’ (MP) is a pragmatic way to think about the management of children with congenital heart disease (CHD). It consists of three phases: diagnosis, treatment and follow-up. Sixteen years ago, the MP in a public hospital in Kenya was assessed, all phases of the MP were found to be inadequate. The objective of the current study was to assess the current status of the CHD MP in the same public hospital in Kenya.
Method: Over a period of one year, patients under 12 years of age, with CHD were consecutively recruited from the general paediatric wards at Kenyatta National Hospital (KNH), Nairobi. All patients required intervention (surgery/cardiac catheterisation) and were followed up for 1-year post-recruitment. Data collected included: age when CHD was first suspected, age at diagnosis, age at intervention, and outcome at 1-year follow-up.
Results: Forty-nine patients were recruited; 47 were reached via mobile phone at 1-year post-recruitment. The mean ages when CHD were first suspected and diagnosed, were 35.3(SD+/-91.1) and 43.4(SD+/- 97) respectively and the mean age at intervention was 47.5(SD +/- 51) weeks. Thirty five percent of all patients had surgery and 96% of all patients were followed-up.
Conclusions: Over the last 16 years, the performance in an at least two phases of the MP may have improved. The proportion of patients who receive surgery has remained the same; resources should be allocated to this phase in the future.
Keywords: Congenital cardiac pathway diagnosis treatment follow-up