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Congenital Heart Disease in Low- and Lower-Middle–Income Countries: Current Status and New Opportunities

  • Global Cardiovascular Health (GY Bukhman, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The paper summarises the most recent data on congenital heart disease (CHD) in low- and lower-middle–income countries (LLMICs). In addition, we present an approach to diagnosis, management and interventions in these regions and present innovations, research priorities and opportunities to improve outcomes and develop new programs.

Recent Findings

The reported birth prevalence of CHD in LLMICs is increasing, with clear evidence of the impact of surgical intervention on the burden of disease. New methods of teaching and training are demonstrating improved outcomes. Local capacity building remains the key.

Summary

There is a significant gap in epidemiological and outcomes data in CHD in LLMICs. Although the global agenda still does not address the needs of children with CHD adequately, regional initiatives are focusing on quality improvement and context-specific interventions. Future research should focus on epidemiology and the use of innovative thinking and partnerships to provide low-cost, high-impact solutions.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgements

LZ is funded by the Medical Research Council of South Africa, the National Research Foundation of South Africa and the Medical Research Council of United Kingdom through the MRCUK/Dfid African Research Leader Award.

Contributor’s Statement

LZ wrote the introduction, conclusion and section on ACHD and developed the tables and figures. LZ collated, contributed to and edited all sections and finalised the manuscript. JL wrote the epidemiology and innovation sections and contributed to diagnosis. GC and BF co-wrote the diagnostics sections, RDD wrote the section on interventions, AB wrote the surgery section and LS contributed to the innovation section. CHH wrote the personal reflection. All authors edited, commented upon and approved the final document.

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Authors and Affiliations

  1. Western Cape Paediatric Cardiology Services, Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and University of Cape Town, 2.17 Institute of Child Health Building, Klipfontein Rd Mowbray, 7700, South Africa

    Liesl Zühlke, George Comitis, Rik De Decker, Lenise Swanson & Christopher Hugo-Hamman

  2. Division of Cardiology, Department of Medicine, Groote Schur Hospital and University of Cape Town, Cape Town, South Africa

    Liesl Zühlke

  3. Western Cape Paediatric Cardiology Services, and Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, 7925, South Africa

    John Lawrenson & Barend Fourie

  4. Chris Barnard Division of Cardiac Surgery, University of Cape Town, Cape Town, South Africa

    Andre Brooks

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  1. Liesl Zühlke
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Correspondence to Liesl Zühlke.

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Liesl Zühlke is funded by the Medical Research Council of South Africa, the National Research Foundation of South Africa and the Medical Research Council of United Kingdom through the MRCUK/Dfid African Research Leader Scheme.

Liesl Zühlke, John Lawrenson, George Comitis, Rik De Decker, Andre Brooks, Barend Fourie, Lenise Swanson and Christopher Hugo-Hamman declare that they have no conflict of interest.

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Zühlke, L., Lawrenson, J., Comitis, G. et al. Congenital Heart Disease in Low- and Lower-Middle–Income Countries: Current Status and New Opportunities. Curr Cardiol Rep 21, 163 (2019). https://doi.org/10.1007/s11886-019-1248-z

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