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Successful training of self-sufficient interventional paediatric cardiology team in a sub-Saharan setting: a
Endale Tefera1, Shakeel A Qureshi2, Ramón Bermudez-Cañete3
11Department of Pediatrics and Child Health,Cardiology Division,School of Medicine,Addis Ababa University,Addis Ababa,Ethiopia.
Insights
Medical teams trained local staff in Ethiopia to perform pediatric cardiac procedures, achieving high success rates and enabling independent interventions. This collaboration improved access to critical heart treatments for children in the region.
Area of Science:
- Cardiology
- Global Health
- Medical Education
Background:
- Limited access to pediatric cardiac treatment in developing nations due to differing healthcare priorities.
- Significant burden of heart disease among children in the Third World.
- Need for specialized interventional cardiology services in sub-Saharan Africa.
Purpose of the Study:
- To assess the feasibility and outcomes of training an interventional cardiology team in Ethiopia.
- To develop sustainable pediatric cardiac services in a resource-limited setting.
- To evaluate the impact of international medical missions on local capacity building.
Main Methods:
- Collaborative missions by "Chain of Hope" and Spanish medical volunteers to Ethiopia since 2009.
- Training of local cardiologists, nurses, and technicians in interventional cardiology procedures.
- Performance of 296 procedures on 287 pediatric patients, including duct occlusions and valve dilations.
Main Results:
- High procedural success rate of 89.2% (264 out of 296 procedures).
- Successful training of local staff, enabling them to perform percutaneous interventions independently.
- Adverse events included three deaths and complications during mitral valve dilation.
Conclusions:
- Training interventional cardiology teams in sub-Saharan Africa is challenging but achievable.
- International collaboration and coordinated missions are crucial for sustainable capacity building.
- The project successfully enhanced local capabilities for pediatric cardiac interventions in Ethiopia.
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.
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