Background: Limited access to treatment and genetic and environmental factors impact the spectrum of pediatric heart disease in sub-Saharan Africa
Objective: Characterize children with heart disease in Uganda.
Methods: Seven medical missions were carried out to Kampala, Uganda (Mulago Hospital) over a 5 year period to diagnose and facilitate treatment of children with heart defects and build a sustainable cardiac surgery program. Diagnoses (echocardiography), age, pulse oximetry, and outcomes were tracked during the 3 most recent missions.
Results: 309 patients were evaluated. Diagnoses included ASD (n=33), VSD (n=46), PDA (n=21), pulmonary stenosis (n=17), TOF (n=58), subaortic stenosis (n=5), atrioventricular septal defect (n=8), truncus arteriosus (n=11), double outlet right ventricle (n=11), TGA (n=10), pulmonary atresia/VSD (n=5), tricuspid atresia (n=6), hypoplastic left heart (n=3), TAPVR (n=3), rheumatic disease (n=5), and cardiomyopathy (n=5). 33 patients had no significant disease. Mean age and pulse oximetry (unrepaired) of the most common defects were: ASD (11 years, 96%), VSD (3.5 years, 95%), and TOF (6.4 years, 82%). 92 patients underwent surgery or catheterization in North America (n=45), Europe (n=3), India (n=12), South Africa (n=2), and Uganda (n=30; 17 open cases). The most common repairs were ASD (n=22), VSD (n=16), TOF (n=25), PDA (n=12), and pulmonary stenosis (n=7). There were 3 post-operative deaths (none in Uganda). 12 children who did not undergo repair died.
Conclusions: There is a preponderance of TOF among Ugandan children referred for cardiac evaluation; other conotruncal anomalies are also highly represented. Effective intervention can be provided for a significant subset of patients.