Clinical epidemiology of atrioventricular septal defects among children at Windhoek Central Hospital, 2015-2020
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Date
2024
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Publisher
University of Namibia
Abstract
Congenital Heart Disease (CHD) accounts for nearly one-third of all birth defects
globally. It is the leading cause of mortality and morbidity among children in low
resource settings. Atrioventricular septal defect (AVSD) accounts for 7.4% of the
cardiac malformations. Since establishment of the only paediatric cardiac service in
Namibia in 2009, number of children diagnosed with CHD has been on an increase.
This study aims to assess the clinical epidemiological burden of AVSDs among
children in Namibia.
A retrospective cohort study (2015-2020) was conducted using a data collection tool
to extract register data of children aged between 0 and 12 years with AVSD at the
Windhoek Central Hospital pediatric cardiology department. Patient’s diagnostic
criteria included clinical and echocardiographic assessment and when relevant, other
cardiac imaging. Bivariate analysis will be used to explore the factors associated with
AVSD at the confidence level of 95%. Multiple logistic regression models retained
significant risk factors at p-value less than 0.05 to determine significant associations.
A total of 91 patients with AVSD were captured in the study. Incidence of AVSD was
0.22 per 1000 children. The male:female ratio was 1:1.3. Trisomy 21 was the most
common genetic syndrome found to be associated with AVSD, accounting for 51.6%
of all AVSD cases. Only an eighth of the cases received corrective cardiac surgery.
Of all the cases, 15.4% AVSD cases were diagnosed with already established
irreversible pulmonary hypertension and among these 4.4% demised. There was a
significant association between AVSD and prematurity with p-value of 0.029.
In conclusion, the study found a significant association between with AVSD and
prematurity. Late referral of patients to cardiology clinics has led to late diagnosis and
hindered them from receiving appropriate treatment. The study calls for an intensified
public health approach to spread the awareness and advocacy of CHD in Namibia
Description
A thesis submitted in fulfilment of the requirements for the degree of masters of science in applied field epidemiology/ laboratory management
Keywords
Congenital Heart Disease, Atrioventricular Septal Heart Defects, Trisomy 21, Windhoek Central Hospital, Namibia