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The unmet need for paediatric and congenital heart services in Accra

The unmet need for paediatric and congenital heart services in Accra. Kow Entsua-Mensah 1* , Rada Bulley 1 , Alfred Doku 1 , Martin Adu-Adadey 1 , Desrie Delsol-Gyan 1 and Frank Edwin 1 . 1 National Cardiothoracic Centre, P. O. Box KB 846,Korle-Bu, Accra, Ghana. 1*Author / Presenter.

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The unmet need for paediatric and congenital heart services in Accra

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  1. The unmet need for paediatric and congenital heart services in Accra Kow Entsua-Mensah1*, Rada Bulley1, Alfred Doku1, Martin Adu-Adadey1, Desrie Delsol-Gyan1 and Frank Edwin1. 1 National Cardiothoracic Centre, P. O. Box KB 846,Korle-Bu, Accra, Ghana. 1*Author / Presenter

  2. Background • Approximately 90% of more than 1,000,000 children who are born with congenital heart disease (CHD) around the world receive suboptimal care or have no access to care. • Approximately 50% of these children will die during their first 5 years of life before they receive any proper treatment. • In Ghana the magnitude of this problem has not been estimated. SeminThoracCardiovascSurgPediatr Card Surg Annu.2010;13(1):35-43. doi: 10.1053/j.pcsu.2010.02.001. Improving pediatric cardiac surgical care in developing countries: matching resources to needs.Dearani JA, Neirotti R, Kohnke EJ, Sinha KK, Cabalka AK, Barnes RD, Jacobs JP, Stellin G, Tchervenkov CI, Cushing JC.

  3. Methods • Retrospective search of the echocardiogram database from January 2006 to December 2010. • All patients less than 15 years diagnosed with a congenital heart disease, CHD, for the first time were selected and entered into the study.

  4. RESULTS • 4,823 new echocardiograms were performed • 4,396 (91.2 %) met the inclusion criteria. • CHD: 60.3% of the enrolled patients. • 2,175 (49.5%) were male whilst 2,221 (50.5%) were female • Male to female ratio of approx. 1:1.

  5. Trimodal age distributionof chdS in accra

  6. Five year Trend in newcases seen in accra

  7. Incidence of Acyanotic congenital heart disease 2006-2010

  8. Incidence of Cyanotic congenital heart disease - 2006-2010

  9. Five commonestchds in accra

  10. SurgERY rate among patientS with ASD, VSD, PDA and TOF 2006 - 2010

  11. Incidence vrsoperated fraction

  12. Decline in operated fraction

  13. DISCUSSION • The vision of the World Society for Pediatric and Congenital Heart Surgery is that every child born anywhere in the world with a CHD should have access to appropriate medical and surgical care. • Children in Ghana / Africa should be no exception to this vision. The improvement of care for paediatric and congenital cardiac disease across the World: a challenge for the World Society for Pediatric and Congenital Heart Surgery. Cardiol Young. 2008 Dec;18 Suppl 2:63-9. doi: 10.1017/S1047951108002801.

  14. CHD burden in ghana • Global incidence of CHD of 0.8% [1] of live births • Estimated population 24 million • Using CBR(31.07 per 1,000 people and IMR(40.9 deaths/1,000 live births) Ghana’s CHD burden may be obtained using the formula: • Population x (CBR–IMR) x 0.008 = number of new children born with CHD. Estimated CHD burden 5,800 per annum Jonas RA. Congenital heart surgery in developing countries. SeminThoracCardiovascSurgPediatr Card SurgAnnu. 2008:3-6. Sandoval N, Kreutzer C, Jatene M, Di Sessa T, Novick W, Jacobs JP, Pierre-Luc Bernier P-L, Tchervenkov CI. Pediatric Cardiovascular Surgery in South America : Current Status and Regional Differences. WJPCHS 2010; 1: 321-327

  15. One problem • Our inability to comprehensively treat all the CHDs we diagnose

  16. What is the barrierto accessibility • FINANCES!!

  17. What needs to be done • Charities and foundations • Corporate organisations • NHIS • Special government budgetary allocation • Heart insurance • Private individuals

  18. Thank you for your ATTENTION

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