We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Spectrum and Determinants of Congenital Heart Defects in Down Syndrome Children Presenting At The University Teaching Hospitals, Children's Hospital.
- Authors
Mumba, Donald; Mtaja, Agnes; Kaonga, Patrick; Mpabalwani, Evans M.
- Abstract
Background: Down syndrome (DS) is the commonest chromosomal abnormality caused by presence of extra genetic material on chromosome 21. Congenital heart defects (CHD) are frequently related with DS, with a global prevalence of 40-60% and a spectrum that varies by geographical region. This study assessed the CHD spectrum, determinants associated with CHD, and phenotypic variations in DS. Methods: In this cross-sectional study conducted between February and November 2020, DS children aged 16 years and below presenting to the University Teaching Hospitals, Children's Hospital in Lusaka, Zambia were recruited based on phenotypic features using K. Fried diagnostic criteria. Participants were assessed using a structured questionnaire, physical examination and two-dimensional colour doppler echocardiography. Data collected was statistically analysed using Stata. Results: Of the 101 DS participants, majority 56 (55.4%) were males. Over two-thirds 71 (70.3% [95% CI: 60.5-78.5]) had CHD with 53.5% (38/71) having single lesions. Atrioventricular Septal Defect (AVSD) was the commonest lesion 14 (19.7%), followed by multiple lesion combinations of AVSD with Patent Ductus Arteriosus (PDA) 9 (12.7%), Atrial Septal Defect (ASD) with PDA 8(11.3%) and a single lesion: secundum ASD 8 (11.3%). PDA was the commonest 47.9% (34/71) lesion seen either as single or in multiple lesion combinations. DS participants were 3% less likely to have a CHD with each increase in unit age (months) (p=0.004). Similarly, there was a 38% reduced chance of having CHD when pulmonary hypertension (PH) was absent(p=0.024). However, an increase in birth order showed no significant difference in risk of having CHD (AOR=1.00; 95% CI: 0.068-1.47; p=0.987). Conclusion: The prevalence of CHD was comparable to studies in Nigeria and Afghanistan, with a CHD spectrum comparable to most other studies elsewhere. The most common lesion was an AVSD. The prevalence of phenotypic characteristics was comparable to South Africa. CHD is more likely in DS children with a history of long-term medicine use and PH. A decreased chance of CHD is associated with an older unit age (months) at presentation. Therefore, the value of early cardiac screening and intervention in improving the quality of life and life span of DS children cannot be overstated.
- Subjects
AFGHANISTAN; LUSAKA (Zambia); NIGERIA; CONGENITAL heart disease; CHILDREN'S hospitals; TEACHING hospitals; UNIVERSITY hospitals; DOWN syndrome
- Publication
Medical Journal of Zambia, 2022, Vol 49, p17
- ISSN
0047-651X
- Publication type
Article