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The global unmet need of congenital cardiac care: a quantitative analysis of the global burden of disease

Published online by Cambridge University Press:  20 August 2020

Dominique Vervoort Open the ORCID record for Dominique Vervoort [Opens in a new window]  and
Marcelo Cardarelli
Dominique Vervoort*
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Marcelo Cardarelli
Affiliation:
Inova Children’s Hospital, Fairfax, Falls Church, VA, USA
*
Author for correspondence: Dominique Vervoort, MD, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, 21205Baltimore, MD, USA. Tel: +1 857 415 9747. E-mail: [email protected]
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Abstract

Background:

CHDs are one of the most frequent congenital malformations, affecting one in hundred live births. In total, 70% will require treatment in the first year of life, but over 90% of cases in low- and middle-income countries receive no treatment or suboptimal treatment. As a result, CHDs are responsible for 66% of preventable deaths due to congenital malformations in low- and middle-income countries. This study examines the unmet need of congenital cardiac care around the world based on the global burden of disease.

Materials and methods:

CHD morbidity and mortality data for 2006, 2011, and 2016 were collected from the Institute for Health Metrics and Evaluation Global Burden of Disease Results Tool and analysed longitudinally to assess trends in excess morbidity and mortality.

Results:

Between 2006 and 2016, a 20.7% reduction in excess disability-adjusted life years and 20.6% reduction in excess deaths due to CHDs were observed for children under 15. In 2016, excess global morbidity and mortality due to CHDs remained high with 14,788,418.7 disability-adjusted life years and 171,761.8 paediatric deaths, respectively. In total, 90.2% of disability-adjusted life years and 91.2% of deaths were considered excess.

Conclusion:

This study illustrates the unmet need of congenital cardiac care around the world. Progress has been made to reduce morbidity and mortality due to CHDs but remains high and largely treatable around the world. Limited academic attention for global paediatric cardiac care magnifies the lack of progress in this area.

Keywords

Global healthglobal surgeryCHDcongenital heart surgeryhealth policyinterventional catheterisation
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 11 , November 2020 , pp. 1688 - 1693
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Meara, JG, Leather, AJM, Hagander, L, et al. Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 2015; 386: 569–624.CrossRefGoogle ScholarPubMed
Neirotti, R. Access to Cardiac Surgery in the Developing World: Social, Political and Economic Considerations, 2007. http://www.fac.org.ar/qcvc/llave/c010i/neirottir.phpGoogle Scholar
Roth, GA, Johnson, C, Abajobir, A, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol 2017; 70: 1–25.CrossRefGoogle ScholarPubMed
Farmer, PE, Kim, JY. Surgery and global health: a view from beyond the OR. World J Surg 2008; 32: 533–536.CrossRefGoogle ScholarPubMed
Zheleva, B, Atwood, JB. The invisible child: childhood heart disease in global health. Lancet 2017; 389: 16–18. http://www.sciencedirect.com/science/article/pii/S0140673616321857CrossRefGoogle ScholarPubMed
Hoffmann, JI. The global burden of congenital heart disease. Cardiovasc J Afr 2013; 24: 141–146.CrossRefGoogle Scholar
Mock, CN, Donkor, P, Gawande, A, et al. Essential surgery: key messages from Disease Control Priorities, 3rd edition. Lancet 2015; 1: 1–11.Google Scholar
Vervoort, D, Meuris, B, Meyns, B, Verbrugghe, P. Global cardiac surgery: access to cardiac surgical care around the world. J Thorac Cardiovasc Surg 2020; 159: 987–996.E6. https://doi.org/10.1016/j.jtcvs.2019.04.039CrossRefGoogle ScholarPubMed
Cardarelli, M, Vaikunth, S, Mills, K, et al. Cost-effectiveness of humanitarian pediatric cardiac surgery programs in low- and middle-income countries. JAMA Netw Open 2018; 1: 1–12.CrossRefGoogle ScholarPubMed
Grimes, CE, Henry, JA, Maraka, J, Mkandawire, NC, Cotton, M. Cost-effectiveness of surgery in low- and middle-income countries: a systematic review. World J Surg 2014; 38: 252–263.CrossRefGoogle ScholarPubMed
Institute for Health Metrics and Evaluation. Global Burden of Disease Results Tool, 2020. Retrieved April 5, 2019, from http://ghdx.healthdata.org/gbd-results-toolGoogle Scholar
Institute for Health Metrics and Evaluation. Protocol for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), 2020. http://www.healthdata.org/sites/default/files/files/Projects/GBD/March2020_GBDProtocol_v4.pdfGoogle Scholar
The World Bank. World Bank Country and Lending Groups, 2020. Retrieved March 30, 2020, from https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groupsGoogle Scholar
World Bank. World Development Open Data, 2020. Retrieved March 10, 2020, from https://data.worldbank.org/Google Scholar
Jackson, JL, Morack, J, Harris, M, DeSalvo, J, Daniels, CJ, Chisolm, DJ. Racial disparities in clinic follow-up early in life among survivors of congenital heart disease. Congenit Heart Dis 2019; 14: 305–310.CrossRefGoogle ScholarPubMed
Chan, T, Lion, KC, Mangione-Smith, R. Racial disparities in failure-to-rescue among children undergoing congenital heart surgery. J Pediatr 2015; 166: 812–814.CrossRefGoogle ScholarPubMed
Chan, T, Pinto, NM, Bratton, SL. Racial and insurance disparities in hospital mortality for children undergoing congenital heart surgery. Pediatr Cardiol 2012; 33: 1026–1039.CrossRefGoogle ScholarPubMed
Vervoort, D, Ma, X, Luc, JGY. Addressing the cardiovascular disease burden in China—is it possible without surgery? JAMA Cardiol 2019; 4: 952–953. https://doi.org/10.1001/jamacardio.2019.2433CrossRefGoogle ScholarPubMed
Sandoval, N, Kreutzer, C, Jatene, M, et al. Pediatric cardiovascular surgery in South America. World J Pediatr Congenit Hear Surg 2010; 1: 321–327.CrossRefGoogle ScholarPubMed
GBD 2017 Child and Adolescent Health Collaborators. Diseases, injuries, and risk factors in child and adolescent health, 1990 to 2017: findings from the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study. JAMA Pediatr 2019; 173: e190337–e190337. https://doi.org/10.1001/jamapediatrics.2019.0337CrossRefGoogle Scholar
Zimmerman, MS, Smith, AGC, Sable, CA, et al. Global, regional, and national burden of congenital heart disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Child Adolesc Heal 2020; 4: 185–200. https://doi.org/10.1016/S2352-4642(19)30402-XCrossRefGoogle Scholar
Yankah, C, Fynn-Thompson, F, Antunes, M, et al. Cardiac surgery capacity in Sub-Saharan Africa: quo vadis? Thorac Cardiovasc Surg 2014; 62: 393–401.Google Scholar
Davis, PJ, Wainer, Z, O’Keefe, M, Nand, P. Cardiac surgery in the Pacific Islands. ANZ J Surg 2011; 81: 871–875.CrossRefGoogle ScholarPubMed
Henry, JA, Price, R. The transforming power of high-quality surgical care: surgery’s role in improving public health. In: Park, A, Price, R (eds). Global Surgery: The Essentials. Berlin: Springer, 2017.Google Scholar
Pezzella, AT. On Location – Vietnam, 2017. https://www.ctsnet.org/article/location-vietnamGoogle Scholar
Mo, X, Yu, D, Shu, Q. Pediatric heart surgery in China: progress and challenges. World J Pediatr Surg 2019; 2: e000048. http://wjps.bmj.com/content/2/1/e000048.abstractCrossRefGoogle Scholar
Vervoort, D. Global cardiac surgery: a wake-up call. Eur J Cardio-Thoracic Surg 2019; 55: 1022–1023.CrossRefGoogle ScholarPubMed