The spectrum of paediatric congenital heart disease at the Kenyatta National Hospital: Implications for surgical care

Abstract

Background Congenital Heart Disease (CHD) is a significant cause of morbidity and mortality amongst infants and children globally. Complex heart lesions are more costly to manage than simple lesions. Geographical differences in the spectrum of CHD have been reported; knowledge of the spectrum of CHD provides a foundation for the rational allocation of health care resources. We undertook a study to determine if the CHD spectrum in Kenya differs from that encountered elsewhere in the globe. Methods A five year retrospective study was carried out at the Kenyatta National Hospital, Nairobi between January 1st 2000 and December 31st 2004. The frequency of selected CHD lesions was examined and compared with that reported from other parts of the world. Results Two hundred and fourteen patients were studied. The mean age at confirmation of diagnosis by echocardiography was 18.6 months. The frequency of ventricular septal defects, atrial septal defects, patent ductus arteriosus, tetralogy of Fallot and transposition of the great arteries, were 18.7%, 4.7%, 10.7%, 8.4%, 6.5% and 4.2% respectively. Conclusion The spectrum of CHD encountered in Kenya may contain more complex lesions than the spectrum found in developed regions of the world. Health resource allocation formulae applied to developed nations may not optimize the care of patients with CHD in developing nations. This may have important implications for health care resource allocation towards CHD in Kenya.