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Prevalence and Case Fatality of Congenital Heart Disease in Pakistani Infants: A 11-Year Retrospective Time-Series
Ijaz Ul Haq1,2,3, Muhammad Imran Khan3, Amir Muhammad4
1Fujian Key Laboratory Of Neonatal Diseases, Children's Hospital of Fudan University at Xiamen, Xiamen Children's Hospital Xiamen Fujian China.
Insights
Congenital heart disease (CHD) cases are rising in Pakistan, with increasing prevalence and fatality rates. Early detection and improved screening are crucial for neonates and infants.
Area of Science:
- Pediatrics
- Cardiology
- Public Health
Background:
- Congenital heart disease (CHD) is a major cause of infant mortality.
- In Pakistan, under-reporting and inadequate screening exacerbate CHD mortality and morbidity.
- Understanding the regional epidemiology of CHD is critical for newborn screening.
Purpose of the Study:
- To determine the prevalence and case fatality rate (CFR) of CHD in neonates and infants.
- To analyze CHD trends over a decade in Buner, Khyber Pakhtunkhwa, Pakistan.
- To inform strategies for early detection and intervention.
Main Methods:
- Retrospective, single-center study using hospital records.
- Data analysis included prevalence, CFR, and time-series analysis.
- Study period covered 11 years of infant data.
Main Results:
- 733 CHD cases identified among 78,713 newborns.
- Overall CHD prevalence increased from 0.86% in 2013 to 1.7% in 2023.
- Case fatality rate (CFR) rose significantly, peaking at 68.1% in 2021.
Conclusions:
- CHD cases, prevalence, and CFR show a consistent upward trend in Buner, Pakistan.
- Enhanced screening protocols for CHD are urgently needed.
- Adoption of electronic health records can improve timely reporting of infant CHD cases.
Background And Aims:
Congenital heart disease (CHD) is a significant cause of infant mortality. In Pakistan, inadequate screening in healthcare settings and under-reporting of CHD cases contribute to high mortality and morbidity rates. This study aimed to determine the prevalence and case fatality rate of CHD over a decade among neonates and post-neonatal infants in Buner, Khyber Pakhtunkhwa (KP), Pakistan. Clarifying the epidemiological profile of CHD in this region is vital for strengthening early detection in newborns.
Methods:
This retrospective, single-center study was conducted at the District Headquarter Hospital, District Buner. Data related to various parameters were extracted from hospital records and presented as prevalence and case fatality rate (CFR). Time-series analysis was performed to assess trends over the years.
Results:
During the study period, a total of 733 cases of CHD were identified among 78,713 newborns. Of these cases, 415 (56.6%) were male infants, while 318 (43.4%) were female. The prevalence rate varied, with a peak in 2023 at 17.05 per 1000 and a trough in 2018 at 5.15 per 1000. Over the 11 years, the overall CFR was 36.7%, with the highest in 2021 at 68.1% and the lowest in both 2015 and 2018 at 27.7% each. The number of CHD cases increased significantly over time, rising from 47 (0.86%) in 2013 to 139 (1.7%) in 2023.
Conclusion:
The data indicate a consistent rise in CHD cases, along with an increasing case fatality rate and prevalence over the years in District Buner, Pakistan. This study underscores the need for improved screening protocols for CHD and the adoption of electronic health records to enable timely reporting of CHD cases among neonates and post-neonatal infants.
