Newborn Screening for Critical Congenital Heart Disease in a Low-Resource Setting; Research Protocol and Preliminary Results of the Tanzania Pulse Oximetry Study.

Autor:	Majani N; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.; Julius Global Health, the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands., Chillo P; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Slieker MG; Department of Paediatric Cardiology, University Medical Center Utrecht, the Netherlands., Sharau G; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania., Mlawi V; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania., Mongella S; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania., Nkya D; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Khuboja S; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania., Kwesigabo G; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Kamuhabwa A; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Janabi M; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania., Grobbee D; Julius Global Health, the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.
Jazyk:	angličtina
Zdroj:	Global heart [Glob Heart] 2022 May 26; Vol. 17 (1), pp. 32. Date of Electronic Publication: 2022 May 26 (Print Publication: 2022).
DOI:	10.5334/gh.1110
Abstrakt:	Background: Critical Congenital Heart Disease (CCHD) is the leading cause of early new-born mortality. Its early detection and intervention is crucial for the survival of affected new-born. Pulse Oximetry (POX) has shown to be one of the feasible, accurate and cost-effective tools in screening CCHD in developed nations, it is yet to be practiced and established as standard of care in a low-resource setting. Objectives: This paper reports on the research protocol and preliminary results of an ongoing study regarding the performance of POX in detecting CCHD in new-borns in a low resource setting. Secondary objectives include investigating the burdens of CCHD and outcome at 12 months of age. Methods: The Tanzanian Pulse Oximetry Study (TPOXS) is a prospective cohort study which plans to enrol 30,000 mothers and new-borns delivered at two referral hospitals in Tanzania. New-borns are offered POX test 12 hours after birth, those positively undergoes echocardiography examinations. Confirmed with CCHD are placed under observation for up to first birthday. Results: During a 5-months pilot period, a total of 1,592 infants at the Muhimbili National Hospital, received POX test .65% of them were post-caesarean section and 52% being male. Most babies delivered through Spontaneous Vertex Delivery (SVD) were promptly discharge and did not get screened. The detection-rate of CCHD was 2.5 per 1,000 live births (at 95% confidence interval [CI] 0.9 to 6.7 per 1000 live birth); with a POX false positive rate of 0.6%. Seven false-positive infants out of 10 were found to carry significant other neonatal conditions, including persistent pulmonary hypertension of the new-born, transient tachypnoeic and neonatal sepsis. Conclusion: This paper provides the protocol of the ongoing TPOXS with the preliminary results showing prevalence matching closely the global data. It shows acceptability of POX screening for CCHD in a well-prepared low resource setting. Highlight: This study addresses the utilization of pulse oximeter in detecting critical congenital heart disease (CCHD) in a low-resource setting (such as sub-Saharan African countries). Competing Interests: The authors have no competing interests to declare. (Copyright: © 2022 The Author(s).)
Databáze:	MEDLINE
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