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Home > Factors Associated With Late Diagnosis of Congenital Heart Disease in Kenya

Factors Associated With Late Diagnosis of Congenital Heart Disease in Kenya

Thesis Info

Author

Ng’Eno-Owino, Mercy Chebet

Department

Paediatrics and Child Health (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2018

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728052485

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Introduction: Congenital heart disease (CHD) is the most common congenital anomaly (one-third of all congenital anomalies) with a global birth prevalence of 8/1,000 live births. About 30-50% of all CHD can be categorized as those that will result in death or long-term disability if surgery or catheter-based intervention is not done within one year (major CHD) or four weeks (critical CHD). Early diagnosis of CHD with subsequent prompt surgical/catheter-based interventions has been associated with better outcomes. In this study, late diagnosis of CHD is defined as cases of CHD diagnosed after the first year of life. Knowledge on presentations of CHD, rates of late diagnosis and associated factors is required to bridge knowledge and care gaps that currently exist locally. Research Question: What are the factors that are associated with late diagnosis amongst children diagnosed with CHD in Kenya? Study Objectives: This study aims to describe the proportion of patients with CHD who are diagnosed late as well as the factors that are associated with the late diagnosis. It also aims to assess access to corrective surgery/catheter-based intervention by children with CHD in Kenya. Study Methods: This is an analytical cross-sectional study of children 18 years and below diagnosed with CHD on follow up at the three major cardiac referral centers in Kenya (Aga Khan University Hospital, Nairobi, Mater Hospital and Kenyatta National Hospital) between January 2011 and December 2016. A total of 411 Patient files were analyzed after randomly selecting patients from all three referral centers based on the number of patients with CHD on follow up in each facility using the ratio (26:75:75). Patients with CHD were categorized into those who were diagnosed late and those who were diagnosed early. Continuous variables were analyzed using summary statistics such as means (ranges) or median (IQR) and categorical and discrete data were analyzed using percentages/proportions. Tests of association between variables and outcome was performed using chi square for categorical and continuous variables and any variable with p-value <0.25 was included in the model. Multiple logistic regression analysis was used to determine factors associated with the late diagnosis of CHD adjusting for age and sex of the patient. P value of <0.05 was considered statistically significant. Results: Out of the 411 patients analyzed, 205 (49.9%) were male and 206 (50.1%) were female. The median (IQR) age at diagnosis was 15 (5-48) months and the proportion of patients with CHD who were
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