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Successful training of self-sufficient interventional paediatric cardiology team in a sub-Saharan setting: a multicentre collaborative model

Published online by Cambridge University Press:  09 June 2014

Endale Tefera ,
Shakeel A. Qureshi  and
Ramón Bermudez-Cañete
Endale Tefera*
Affiliation:
Department of Pediatrics and Child Health, Cardiology Division, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
Shakeel A. Qureshi
Affiliation:
Evelina London Children’s Hospital, Guys and St Thomas’ Foundation Trust, London, United Kingdom
Ramón Bermudez-Cañete
Affiliation:
Department of Pediatric Cardiology, Ramon y Cajal University Hospital, Madrid, Spain
*
Correspondence to: Dr E. Tefera, MD, Department of Pediatrics and Child Health, Cardiology Division, School of Medicine, Addis Ababa University, P. O. Box 1768, Addis Ababa, Ethiopia. Tel: +251 911 806126; Fax: +251 115 153099; E-mail: [email protected]
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Abstract

Background: Most children in the Third World do not have access to treatment for heart diseases, as the priorities of health care are different from the developed countries. Materials and methods: Since 2009, teams supported by the Chain of Hope and Spanish medical volunteers have travelled twice a year to help develop paediatric cardiac services in the Cardiac Center in Ethiopia, undertaking four missions each year. As of December 2012, 296 procedures were performed on 287 patients. The procedures included 128 duct occlusions, 55 pulmonary valve dilations, 25 atrial septal defect closures, 14 mitral valve dilations, and others. The local staff were trained to perform a majority of these cases. Results: Procedural success was achieved in 264 (89.2%). There were three deaths, five device embolisations, and three complications in mitral valve dilation. During the visits, the local staff were trained including one cardiologist, six nurses, and two technicians. The local team performed percutaneous interventions on its own after a couple of years. The goal is also to enable the local team to perform interventions independently. Conclusion: Training of an interventional cardiology team in a sub-Saharan setting is challenging but achievable. It may be difficult for a single centre to commit to sending frequent missions to a developing country to make a meaningful contribution to the training of local teams. In our case, coordination between the teams from the two countries helped to achieve our goals.

Keywords

Interventional catheterisationpaediatric cardiology servicesub-Saharan setting
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 5 , June 2015 , pp. 874 - 878
Copyright
© Cambridge University Press 2014 

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References

1. Kumar, RK, Tynan, MJ. Catheter interventions for congenital heart disease in third world countries. Pediatr Cardiol 2005; 26: 241–249.CrossRefGoogle ScholarPubMed
2. Yacoub, MH. Establishing pediatric cardiovascular services in the developing world: a wake-up call. Circulation 2007; 116: 1876–1878.CrossRefGoogle ScholarPubMed
3. Leblanc, JG. Creating a global climate for pediatric cardiac care. World J Pediatr 2009; 5: 89–92.CrossRefGoogle ScholarPubMed
4. Tchervenkov, CI, Jacobs, JP, Bernier, PL, et al. The improvement of care for paediatric and congenital cardiac disease across the world: a challenge for the World Society for Pediatric and Congenital Heart Surgery. Cardiol Young 2008; 18: 63–69.CrossRefGoogle ScholarPubMed
5. Hewitson, J, Brink, J, Zilla, P. The challenge of pediatric cardiac services in the developing world. Semin Thorac Cardiovasc Surg 2002; 14: 340–345.CrossRefGoogle ScholarPubMed
6. Rao, SG. Pediatric cardiac surgery in developing countries. Pediatr Cardiol 2007; 28: 144–148.CrossRefGoogle ScholarPubMed
7. Kalangos, A. A humanitarian association for the promotion of cardiology and cardiac surgery in developing countries. Ann Thorac Surg 2002; 73: 341–350.CrossRefGoogle ScholarPubMed
8. Köhler, F, Schierbaum, C, Konertz, W, et al. Partnership for the heart. German-Estonian health project for the treatment of congenital heart defects in Estonia. Health Policy 2005; 73: 151–159.CrossRefGoogle ScholarPubMed
9. Vastag, B. Volunteers see the world and help its people. JAMA 2002; 288: 559–565.Google ScholarPubMed
10. Tomita, H, Haneda, N, Higaki, T, Kataoka, K. Successful introduction of interventional catheterisation and other paediatric cardiology services in a developing country. Cardiol Young 2013; 23: 405–408.CrossRefGoogle ScholarPubMed
11. Senga, J, Rusingiza, E, Mucumbitsi, J, et al. Catheter interventions in congenital heart disease without regular catheterization laboratory equipment: the chain of hope experience in Rwanda. Pediatr Cardiol 2013; 34: 39–45.CrossRefGoogle ScholarPubMed
12. Novick, WM, Di Sessa, TG. Fourteen years of humanitarian pediatric cardiac assistance: The International Children’s Heart Foundation, 2008. Retrieved March 22, 2014, from http://wwweplabdigestcom/article/7443 Google Scholar
13. World Health Organization. Ethiopia. Retrieved November 15, 2013, from http://www.who.int/countries/eth/en/2013 Google Scholar
14. Oli, K, Porteous, J. Prevalence of rheumatic heart disease among school children in Addis Ababa. East Afr Med J 1999; 76: 601–605.Google ScholarPubMed
15. Casanova, R, Selman-Houssein, E, Palenzuela, H, et al. Cuba’s National Pediatric Cardiology Program. MEDICC Rev 2010; 12: 6–9.Google ScholarPubMed
16. Tefera, E, Qureshi, SA, Bermudez-Cañete, R, Rubio, L. Percutaneous balloon dilation of severe pulmonary valve stenosis in patients with cyanosis and congestive heart failure. Catheter Cardiovasc Interv 2013, doi:10.1002/ccd.25324 [Epub ahead of print].Google Scholar
17. Giamberti, A, Mele, M, Di Terlizzi, M, et al. Association of children with heart disease in the world: 10-year experience. Pediatr Cardiol 2004; 25: 492–494.CrossRefGoogle Scholar