The Status of Congenital Heart Defects in Nigeria and Challenges of Surgical Treatment: 6 Year Review

Abstract

Background: Unlike in developed countries, the delivery of cardiovascular services to patients born with CHD in Nigeria is grossly inadequate. There are problems at both pediatric and adult ages with high morbidity and mortality. We aim to highlight the status of the patients born with CHD, and the challenges of their surgical management. Materials and Methods: In the last 6 years, Foreign Cardiac Surgery missions were reinstituted at NCTCE/UNTH, Enugu, Nigeria. The participants performed cardiac interventions on a variety of patients with CHD. We performed a retrospective review of this endeavor. Patient demographics, number of patients, age ranges, types of CHD and clinical evaluation methodology were obtained from our hospital information technology department. We assessed the types of cardiac interventions, the outcome and the challenges including the impacts of the foreign cardiac surgery missions. Results: During the study period, a total of 113 patients with CHD were evaluated. They were 61 males and 52 females with a ratio of 1.2:1. We studied both simple and complex anomalies. The highest age range affected was 1.1- 2 years followed by 2.1-3 years. A VSD was the commonest anomaly (n=32, 24.6%), followed by tetraology of Fallot (n=25, 19.2%). One of the commonest challenges is inadequate educational program for the local team. Conclusion: Large burden of diseases on limited health care resources and lack of trained personnel have made Nigeria to rely on Foreign Cardiac Missions. However inadequate educational program for the local team has created lack of independence of the local to treat CHD after 6 years.