NEWBORN SCREENING FOR CONGENITAL HEART DISEASES USING PULSE OXIMETRY AND NEWBORN CLINICAL EXAMINATION IN TWO TERTIARY CENTRES IN ACCRA, GHANA

Author: Daem Celestin. Prof. Nana-Akyaa Yao MD.

Area of Concentration: Global Health Equity Pathway

Keywords: Pediatric, Cardiology, Congenital Heart Disease 

Background:

Critical congenital heart disease (CCHD) is defined as a life-threating heart defect that requires an intervention within the first year of life. 25% of all congenital heart disease cases are critical and require surgery or a catheter-based intervention within the first 28 days of life. In 2019 the global CHD deaths were reported as 217,000. It is estimated that 500,000 children are born in Africa with CHD each year. 

Objective:

This project aims to identify the incidence of critical congenital heart in 3 tertiary centers in Accra, Ghana. This 3-month preliminary report explores the results of using pulse oximetry and newborn physical exam as a screening tool for critical congenital heart disease in a low-resource setting.

Methods:

In this descriptive, cross-sectional study mothers were identified via labor and delivery records and were consented on the post-natal ward. All newborns under the age of 48 hours were screened with pulse oximetry and were examined shortly after. Those who failed pulse oximetry underwent an echocardiogram examination. 
 

Results:

A total of 2100 newborns were screened. 1467 neonates were screened at Korle Bu Teaching Hospital and 617 at 37 Military Hospital, 70.4%, and 29.6% respectively. The median age of the patients was 20 hours old. 14 newborns failed pulse oximetry screening (0.6%) and 13 neonates had abnormal cardiac exams. Of these, 4 patients were diagnosed with CCHD via echo (0.19%) and an additional 3 had major cardiac defects. At 37 Military Hospital, 3 patients out of 617 (0.48%) were diagnosed with a CCHD. 

Conclusion:

This study shows a significantly higher rate of CCHD compared to other studies in similar settings with a rate of 2.5 out of 1,000. Research is needed in this field to understand the rate of CCHD in Ghana. Most importantly, there is a critical need for robust cardiac care and affordable surgical options.