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Browsing Directorate of Postgraduate Studies by Author "Fakih, Zameer A."

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    Prevalence of and parental risk factors associated with delayed diagnosis of congenital heart diseases in children at Muhimbili national hospital
    (Hubert Kairuki Memorial University, 2018) Fakih, Zameer A.
    Background - Delayed diagnosis of CHD is a significant public health problem in SSA Tanzania included. This is mostly due to lack of diagnostic facilities in the peripheral health facilities. In Tanzania only two hospitals are able to diagnose CHDs including JKCI and Bugando Medical Centre. Such delay is associated with serious long term complications including disabilities and death. The Objectives of this study was to determine the prevalence, pattern and risk factors associated with delayed diagnosis of congenital heart diseases at the Jakaya Kikwete Cardiac Institute. Methods - A hospital based cross sectional study was carried out at the children’s outpatient clinic at JKCI from November 2017 to April 2018. Children below 15 years of age with CHDs were randomly selected for enrollment. Our outcome variable was delayed diagnosis that was defined as any child diagnosed with CHD 6 months after birth. Mothers were interviewed and information entered on questionnaires. Data was entered in Microsoft Excel and analyzed using Epi Info version 7. Categorical variable was summarized using Frequency and proportion while continuous variable was summarized using measure of central tendency and dispersion. Bivariate and multivariate analysis was done where odds ratio was used as a measure of association. Chi square with 95% CI and p-value was used as a measure of statistical significance. Results - The median age of studied children was 27 months ranging from 8 days to 14 years. Female contributed 51.7% (n=155) while 61% (n=183) of participants came from upcountry. Most 249 (83%) children were below one year of age. Prevalence of late diagnosis was 52% (n=155). Acyanotic CHDs contributed 62% (n=187) of delayed diagnosis, VSD 33% (n=101) being the commonest ACHD, followed by PDA 13% (n=40) and TOF which accounted for 21% (n=63) of the cases. The odds of delayed diagnosis was 1.95 times higher among mothers who had low education level (AOR 1.95, 95%CI 1.12 to 3.4, at P <0.05) while mothers who were unmarried were 0.4 times more likely to have their children diagnosed late for CHD (AOR 0.5, 95%CI 0.32 to 0.85, at P <0.05).vi Other factors that were associated with late diagnosis of CHD included were low socioeconomic status with (AOR 1.5, 95%CI 0.79 to 2.95, at P< 0.05), and unemployment (OR 0.71, 95% CI 0.42 to 1.2 at <0.05). Conclusion - The current study found a high prevalence of congenital heart diseases, the majority of which were diagnosed late when nothing much could be done. The delayed diagnosis of CHD in this study was mostly due to delay of mothers to seek early health care services for their sick children. The study found a significant association between delayed diagnosis of CHD with poverty, single parents, unemployment and low level of education. Recommendations - Improving social economic status of the parents, in terms of their education and employment as well as stable marital status may motivate parents to seek early health care provision for their children with CHD that way reduce the burden of CHDs associated with late diagnosis. Key words: Congenital heart diseases, Delayed diagnosis, Parental risk factors, children.