The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project
| dc.contributor.advisor | Zühlke, Liesl Joanna | |
| dc.contributor.advisor | Hugo-Hamman, Christopher | |
| dc.contributor.author | Shidhika, Fenny Fiindje | |
| dc.date.accessioned | 2019-02-19T13:35:25Z | |
| dc.date.available | 2019-02-19T13:35:25Z | |
| dc.date.issued | 2018 | |
| dc.date.updated | 2019-02-19T10:46:16Z | |
| dc.description.abstract | Introduction: Congenital and acquired heart diseases are highly prevalent in developing countries despite limited specialised care. Namibia established a paediatric cardiac service in 2009 with significant human resource and infrastructural constraints. Therefore, patients are referred for cardiac interventions to South Africa. Objectives: To describe the diagnoses, clinical characteristics, interventions, post-operative morbidity and mortality and follow-up of patients referred for care. Methods: Demographics, diagnoses, interventions, intra- and postoperative morbidity and mortality as well as longitudinal follow-up data of all patients referred to South Africa were recorded and analysed. Results: The total cohort constituted 193 patients of which 179 (93%) had congenital and 7% acquired heart disease. The majority of patients (78.8%) travelled more than 400 km to Windhoek prior to transfer. There were 28 percutaneous interventions. Palliative and definitive surgery was performed in 27 and 129 patients respectively. Eighty (80/156, 51.3%) patients had postoperative complications, of which 15 (9.6%) were a direct complication of surgery. Surgical mortality was 8/156 (5.1%, 95% confidence interval 1.2.2-9.8), with a 30- day mortality of 3.2%. Prolonged ICU stay was associated with a 5% increased risk of death (Hazard Ratio 1.05, 95% confidence interval: 1.02-1.08, p=0.001). Follow-up was complete in 151 (78%) patients over seven years. Conclusions: Despite the challenges associated with a cardiac programme referring patients for intervention to a neighbouring country and the adverse characteristics of multiple lesions and complexity associated with late presentation, we report good surgical and interventional outcomes. Our goal remains to develop a comprehensive sustainable cardiac service in Namibia. | |
| dc.identifier.apacitation | Shidhika, F. F. (2018). <i>The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/29683 | en_ZA |
| dc.identifier.chicagocitation | Shidhika, Fenny Fiindje. <i>"The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2018. http://hdl.handle.net/11427/29683 | en_ZA |
| dc.identifier.citation | Shidhika, F. 2018. The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project. University of Cape Town. | en_ZA |
| dc.identifier.ris | TY - Thesis / Dissertation AU - Shidhika, Fenny Fiindje AB - Introduction: Congenital and acquired heart diseases are highly prevalent in developing countries despite limited specialised care. Namibia established a paediatric cardiac service in 2009 with significant human resource and infrastructural constraints. Therefore, patients are referred for cardiac interventions to South Africa. Objectives: To describe the diagnoses, clinical characteristics, interventions, post-operative morbidity and mortality and follow-up of patients referred for care. Methods: Demographics, diagnoses, interventions, intra- and postoperative morbidity and mortality as well as longitudinal follow-up data of all patients referred to South Africa were recorded and analysed. Results: The total cohort constituted 193 patients of which 179 (93%) had congenital and 7% acquired heart disease. The majority of patients (78.8%) travelled more than 400 km to Windhoek prior to transfer. There were 28 percutaneous interventions. Palliative and definitive surgery was performed in 27 and 129 patients respectively. Eighty (80/156, 51.3%) patients had postoperative complications, of which 15 (9.6%) were a direct complication of surgery. Surgical mortality was 8/156 (5.1%, 95% confidence interval 1.2.2-9.8), with a 30- day mortality of 3.2%. Prolonged ICU stay was associated with a 5% increased risk of death (Hazard Ratio 1.05, 95% confidence interval: 1.02-1.08, p=0.001). Follow-up was complete in 151 (78%) patients over seven years. Conclusions: Despite the challenges associated with a cardiac programme referring patients for intervention to a neighbouring country and the adverse characteristics of multiple lesions and complexity associated with late presentation, we report good surgical and interventional outcomes. Our goal remains to develop a comprehensive sustainable cardiac service in Namibia. DA - 2018 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project TI - The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project UR - http://hdl.handle.net/11427/29683 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/29683 | |
| dc.identifier.vancouvercitation | Shidhika FF. The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project. []. University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2018 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/29683 | en_ZA |
| dc.language.iso | eng | |
| dc.publisher.department | Department of Paediatrics and Child Health | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.publisher.institution | University of Cape Town | |
| dc.subject.other | Paediatric Cardiology and Critical Care | |
| dc.title | The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project | |
| dc.type | Master Thesis | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationname | MPhil |