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Detection rates of congenital heart disease in Guatemala

Published online by Cambridge University Press:  08 December 2010

Sara M. Trucco ,
Joaquin Barnoya ,
Luis Alesandro Larrazabal ,
Aldo Castañeda  and
David F. Teitel
Sara M. Trucco*
Affiliation:
Pediatric Cardiology, University of California San Francisco, San Francisco, California, United States of America
Joaquin Barnoya
Affiliation:
Pediatric Cardiothoracic Surgery, Unidad de Cirugia Cardiovascular de Guatemala, Guatemala City, Guatemala Department of Surgery, Washington University in St. Louis School of Medicine, Saint Louis, Missouri, United States of America
Luis Alesandro Larrazabal
Affiliation:
Pediatric Cardiology, University of California San Francisco, San Francisco, California, United States of America
Aldo Castañeda
Affiliation:
Pediatric Cardiothoracic Surgery, Unidad de Cirugia Cardiovascular de Guatemala, Guatemala City, Guatemala
David F. Teitel
Affiliation:
Pediatric Cardiology, University of California San Francisco, San Francisco, California, United States of America
*
Correspondence to: S. M. Trucco, MD, Pediatric Cardiology, University of California, San Francisco, 505 Parnassus Avenue, PO Box 0544, San Francisco, California 94143, United States of America. Tel: 415 353 4141; Fax: 415 353 4144; E-mail: smtrucco@gmail.com
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Abstract

Objectives

In developing countries, congenital heart disease is often unrecognised, leading to serious morbidity and mortality. Guatemala is one of the few developing countries where expert paediatric cardiac treatment is available and affordable, and therefore early detection could significantly improve outcome. We assessed regional congenital heart disease detection rates in Guatemala, and determined whether they correlated with the regional human development index.

Methods

We retrospectively reviewed all new cardiac referrals made in 2006 to the Unidad de Cirugia Cardiovascular Pediatrica, the only paediatric cardiac centre in Guatemala. We calculated regional detection rates by comparing the number of congenital heart disease referrals with the expected incidence using the National Ministry of Health birth data. We then compared the regional detection rates with the human development index data published in the United Nations 2006 Development Program Report using Spearman’s rank correlation.

Results

An estimated 3935 infants with cardiac defects were born in Guatemala in 2006, an expected 1380 (35%) of whom had severe forms. Overall, only 533 children (14%) with cardiac defects were referred. Of these, 62% had simple shunt lesions, 13% had cyanotic lesions, and 10% had left-sided obstructive lesions. Only 11.5% of referred patients were neonates. Regional detection rates, ranged 3.2–34%, correlated with the regional human development index (r = 0.75, p < 0.0001).

Conclusions

Current detection of congenital heart disease in Guatemala is low and correlates with the regional human development index. Those detected are older and have less severe forms, suggesting a high mortality rate among Guatemalan neonates with complex cardiac defects.

Keywords

Human development indexdeveloping countrieshealthcare deliveryunderserved populations
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 2 , April 2011 , pp. 153 - 160
Copyright
Copyright © Cambridge University Press 2010

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