Paediatric heart failure in Uyo A retrospective analysis

heart failure is a condition that continues to present challenges in management in our environment especially in its treatment and outcomes hence the aim of this study. Materials and Methods: A retrospective analysis of the case notes of all children who were diagnosed and managed for heart failure from January 2019 ­ October 2021 was undertaken. Data obtained included age, sex, presenting features, primary diagnosis, treatment modalities, duration of hospital stay and outcomes. Results: A total of 2226 children were admitted over the study period with 67 children diagnosed with heart failure giving a prevalence rate of 3% although only 47 case notes could be retrieved giving a case retrieval rate of 70%. There were 26 (55.3%) males and 21 (44.7%) females (M: F ratio1.2:1). Mean age of patients was 32.6 months (±52.23) with 28(59.6%) of them being infants. Bronchopneumonia was the commonest cause of heart failure 31 (65.9%) either singly or in combination with a cyanotic congenital heart disease followed by severe anemia in 14 (29.8%). Average duration of hospital stay was 6.9days (±5.08) and average cost of admission was N13,266. Twenty-three patients were discharged (48.9%), while 10 (21.3%) left against medical advice, 2 absconded (4.3%) while 12 (25.3%) died. Conclusion: Heart failure remains an important cause of morbidity and mortality in children in our environment arising from largely preventable causes. Urgent steps such as patient care giver education, immunization and screening for congenital heart disease are needed to reduce its effect on children in our environment

Prevalence and Determinants of Depression among Caregivers of Children with Heart Diseases in Nigeria

Context: Caregivers of children with heart diseases are faced with the long term care of these children and may suffer psychological illnesses as a result.Aims: To determine the prevalence and determinants ofdepression among caregiversof children with heart diseases attending two Out-patient clinics in South-SouthNigeria. Materials and Methods:It was a cross-sectional study involving the use of the revised Center for Epidemiological Studies Depression (CESD-R) questionnaire. Data were entered into an Excel spreadsheet and analyzed using SPSS 22.0.Results: Ages of the participants ranged from 24 to 59 years with a mean age of 37.49 years (SD 6.973) and majority were female (79.9%). The overall mean CESD-R score was 8.61 (SD 16.18), ranging from 0 to 60. There was a significant difference in the CESD-R scores between male and female participants (t=2.362, p=0.02) with females scoring higher than males (10.24± 17.69 and 2.15± 3.13) respectively.Overall, depression was found among 23(17.1%) participants. Depression was significantly associated with the female sex (x2=7.006, p=0.009), a history of a mental health illness in the past (x2=66.496, p=0.029)and the marital status of the participants (x2=19.776, p=0.05). No significant relationship was found between depression and age, religion, tribe and educational status (p>0.05), history of medical illnesses (x2=53.006, p=0.538) or type of heart disease the children/wards of the participants were being managed for (x2=8.274, p=0.902). Conclusion: The rate of depression among caregivers of children being managed for congenital and acquired heart diseases in this study is significant. It is recommended that caregivers of children with congenital and acquired heart diseases are routinely given relevant psychosocial support to prevent the development of depression. Routine screening for depression and appropriate intervention for those who meet the criteria is also recommended.