Challenges in congenital heart disease in the Amazon region countries: A scoping review

Abstract

ABSTRACT Introduction: This study aimed to systematically analyze and describe the main challenges of congenital heart diseases (CHDs) in the countries in the Amazon region. Methods: The methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist utilizing the Medline, Embase, Lilacs, and Google Scholar databases. The inclusion criteria were articles addressing any topic involving CHD in the Amazon region. Incomplete articles, book chapters, lectures, conference abstracts, and editorials were excluded. Results: Nine studies were identified, 7 of which were published in the last decade and were of Colombian and Brazilian origin. The methodology of the studies was cross-sectional and ecological, evaluating the regional and epidemiological factors, challenges to diagnosis and treatment, multidisciplinary team challenges, and the impact of the COVID-19 pandemic. Studies carried out by surgeons demonstrate more existing data regarding the challenges of the health-care system. Conclusions: There is growing interest in analyzing the situation of CHD in the region. However, only a few studies are available, mostly on ecological and cross-sectional analysis. These records show the lack of hospital infrastructure and multidisciplinary teams for the diagnosis and treatment of CHD in the Amazon region; we see an initiative by specialists from two countries (Colombia and Brazil) to demonstrate the difficulties by seeking international training programs and government aid to improve the health system situation.