PREVALENCE OF CONGENITAL HEART DISEASE IN RURAL COMMUNITIES OF PAKISTAN
Abstract
Background: Prevalence of Congenital Heart Disease (CHD) is well established in most of the developed countries, where childbirth is obligatory in hospitals and allied facilities. In rural Pakistan the situation is reverse, where most of deliveries take place in homes by traditional birth attendants’ therefore true prevalence of CHD in our population is unknown. In rural Pakistan almost 80% children are born at home hence the figures are unknown. This study was designed, to determine the prevalence of congenital heart disease in rural Pakistan. Methods: During a cross-sectional survey of rural population belonging to major ethnic groups living in three provinces of Pakistan to determine the prevalence of rheumatic heart disease (RHD), CHD rates were calculated as a sub study. Nine thousand four hundred and seventy-six (9476) subjects of all ages were screened using cluster sampling technique. Socio-demographic variables were recorded. Auscultation and short physical examination performed for initial screening and final diagnosis was confirmed on M-mode/2D/Doppler. Results: Thirty two patients had RHD, 25 Patients identified with CHD and another 7 patients had mixed CHD & RHD. Overall prevalence for CHD was 3.4/1000. The commonest lesion was Atrial Septal Defect (ASD) 40%, Ventricular Septal Defect (VSD) 35%, Aortic Stenosis (AS) 10%, Atrio Ventricular Septal Defect (AVSD) 5%. Conclusion: This is the first study to report CHD prevalence from multiethnic representative sample from rural communities of Pakistan. Apparently CHD rate seems less compared with facility based data because records of still stillbirths are not available and autopsies are not performed as routine. Very high infant mortality from rural areas of Pakistan also favours high prevalence for CHD; however these figures represent an overall picture of CHD in a community where medical facilities are lacking.Keywords: congenital heart disease, Prevalence, Rural communitiesReferences
Williams RG, Pearson GD, Barst RJ, Child JS, del Nido P, Gersony WM et al. Report of the National Heart, Lung, and Blood Institute Working Group on Research in Adult Congenital Heart Disease. J Am Coll Cardiol 2006;47(4):701–7.
Russell IA, Rouine-Rapp K, Stratmann G, Miller-Hance WC. Congenital Heart Disease in the Adult: A Review with Internet-Accessible Transesophageal Echocardiographic Images. Anesth Analg 2006;102:694–723
Murphy DJ Jr. Pediatric Cardiology and Adult Congenital Heart Disease. J Am Cardiol 2004;44(2 Suppl A):23A–24A.
Buskins E, Grobbec DE, Frohn-Mulder IM, Stewart PA, Juttmann RE, Wladimiroff JW, et al. Efficiency of routine fetal ultrasound screening for CHD in normal pregnancy. American heart Association. Circulation 1996:94;67–72.
Hoffman JI, Kaplan S, Liberthson RR. Prevalence of congenital heart disease. Am Heart J 2004;147(3):425–39.
Marelli AJ, Mackie AS, Ionescu-Ittu R, Rahme E, Pilote L. Congenital Heart Disease in the General Population, Changing Prevalence and Age Distribution. Circulation. 2007;115:163–72
Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002;39:1890–900.
Sadiq M, Islam K, Abid R, Latif F, Rehman AU, Waheed A, et al. Prevalence of rheumatic heart disease in school children of urban Lahore. Heart 2009;95(5):353–7.
Ahmad R, Awan ZA, Bukshi F. A prevalence study of congenital heart disease in NWFP, Pakistan. Pak J Med Sci 2002;18(2):95–8.
Burki MK, Babar GS. Prevalence and Pattern of Congenital Heart Disease in Hazara. J Ayub Med Coll Abbottabad 2001;13(4):16–8.
Sadiq M, Roshan B, Khan A, Latif F, Bashir I, Sheikh SA. Pediatric Heart Disease in Pakistan - epidemiological data on 6620 patients. Pak Paed J 2001;25(2):63–70.
Chesney M, Davies SE. Women's birth experiences in Pakistan—the importance of the Dai. Evidence Based Midwiery 2005;3(1):26–32.
Rizvi SF, Khan MA, Kundi A, Marsh DR, Samad A, Pasha O. Status of rheumatic heart disease in Pakistan. Heart 2004;90:394–9.
Unicef Pakistan-statistics. Retrieved from; http://www.unicef.org/infobycountry/pakistan_pakistan_statistics.html.
Freeman SB, Bean LH, Allen EG, Tinker SW, Locke AE, Druschel C, et al. Ethnicity, sex, and the incidence of congenital heart defects: a report from the National Down Syndrome Project. Genet Med 2008;10(3):173–80.
Misra M, Mittal M, Verma AM, Rai R, Chandra G, Singh DP, et al. Prevalence and pattern of congenital heart disease in school children of eastern Uttar Pradesh. Indian Heart J 2009;61(1):58–60.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.