Prevalence and Factors Associated With Delayed Diagnosis of Congenital Heart Disease at Kenyatta National Hospital

Abstract

Congenital heart diseases are malformations of the heart and cardiovascular system that are present from birth and are associated with or without cyanosis. They are the most common congenital abnormality with an incidence of 8:1000. Without timely diagnosis and intervention, Critical congenital heart disease (CCHD) has an associated overall 30% mortality, with 50% occurring within the first year of life in LMIC. Delayed diagnosis is defined as cyanotic heart disease diagnosed after the first week of life and acyanotic heart disease diagnosed after 3 months. Late diagnosis leads to late intervention resulting in a high morbidity and mortality. The purpose of study: To assess the prevalence and factors associated with delayed diagnosis of CHD at Kenyatta National hospital. Methodology: This was a cross-sectional study carried out in KNH in the children with CHD. Consecutive sampling was done until the desired sample size of 257 was attained. Relevant demographic information was obtained via a structured and detailed questionnaire. Binary logistic regression was conducted to investigate factors associated with delayed diagnosis. Further analysis was done using both descriptive and inferential analysis. Results: In the total population of 257 children with CHD, 222 had delayed diagnosis giving a prevalence 86.4%. 65.9% were under 5 years, 55.6% were female and 75.3% were referred. On multivariable analysis monthly income of less than Ksh.13, 500, no murmurs and referrals were independently associated with delayed diagnosis. 8 Conclusion and recommendations 86.4% of patients with CHD were diagnosed late. Factors associated with delayed diagnosis were female gender, birth weight of >1.8kgs, children of multiparous mothers. A monthly income of less than Ksh.13, 500, no murmurs and referrals were independently associated with delayed diagnosis. Community screening and awareness of CHD, early referrals would reduce the delay in diagnosis of CHD