The The Prevalence and Pattern of Cardiac Disease Amongst the Pediatric Age Group in Liberia: A Five-Year Retrospective Cohort Study at the John F. Kennedy Medical Center

Abstract

Background: Cardiac disease is a huge public health problem for developing countries. Access to healthcare and diagnostic technologies are known to impact the reported prevalence of heart diseases globally. Objective: The objective of the research is to determine the number and patten of heart diseases amongst the pediatric age group in Liberia and set a platform for investment in cardiac surgery. Methods: We conducted a five-year retrospective study at the John F. Kennedy Medical Center to determine the prevalence of cardiac disease in Liberia. A total of 175 patients were enrolled. Data were analyzed using Excel 2019, Epi Info version 3.5.3 and SPSS V.27 Results: The prevalence of cardiac disease was 7.6 per 1000 live birth. Male to female ratio was 1:1.5. 40.5% of children were diagnosed during toddler and early adolescent while 56.6% were diagnosed during infancy and 2.9% during the neonatal period. Commonest pathologies were ventricular septal defect, acquired heart disease, patent ductus arteriosus and tetralogy of fallot. Diagnosis was made mainly by history and physical evaluation. Easily fatiguability, dyspnea and murmur were the commonest sign/symptoms. Down syndrome was the most common associated anomalies. 87.4% of children had no surgical treatment and the status of 72.6% were unknown. Conclusion: Pediatric cardiac diseases is one of the neglected non-communicable clinical diseases in Liberia with a prevalence of 7.6 per 1000 live birth. An estimated 41,600 children are living with cardiac disease in Liberia with over 87% not having any chance of receiving surgical treatment while a very few are being flown out of the country for treatment. More than 77% of the parents of these children are discouraged from bringing their kids for follow ups as they have grown exhausted from repeated hospital visits without any solution. Also, diagnosis of these conditions is a challenge for doctors in Liberia as many of them have not been trained to make early diagnosis and major diagnosis tools are relatively absent as there is only one cardiothoracic surgeon and one cardiology in the country. Ventricular septal defect, acquired heart disease, patent ductus arteriosus and tetralogy of fallot were among the commonest presenting pediatric cardiac disease.