High prevalence of congenital heart disease among hospitalized neonates in northwestern Tanzania; implications of maternal and environmental factors

Abstract

There is paucity of epidemiological data on neonatal congenital heart disease (CHD) in Tanzania, hindering evidence based policy or protocol development and resources allocation to improve health care services. Consequently, neonates with CHD are subjected to late referrals, disease complications and high treatment costs. This study aimed to determine prevalence, patterns, and factors associated with CHD among neonates admitted to a tertiary hospital, northwestern-Tanzania. ology: A cross-sectional study was conducted from November 2022 to March 2023 involving 513 admitted neonates. Detailed physical examination and screening echocardiography was done to all participants. Data was analyzed using STATA version 13. The overall prevalence of CHD was 20.3% (104/513) which decreased to 10.3% (53/513) after excluding small defects with high likelihood of spontaneous closure. From the overall CHD, acyanotic CHD were the commonest by 83.7% (87/104). Severe CHD accounted for 6.8% (35/513). History of residing near mining areas (OR 2.9[CI: 1.2–6.9], P-0.017) and lack of folic acid supplementation during the first trimester (OR 2.5[CI: 1.4–4.4], P- 0.001) were significant maternal risk factors. While, Pre-ductal oxygen saturation of <90% (OR 3.2[CI: 1.4–7.3], P-0.005), tachycardia (OR 2.8[CI: 1.3–5.9], P-0.007), and presence of central cyanosis (OR 3.9[CI: 1.1–13.6], P-0.031) were significant clinical predictors. Strategies are needed to strengthen reproductive health services among women of child bearing age and promote environmental health policies in mining and nearby areas. Clinicians are urged to perform thorough cardiovascular examination together with diagnostic services to facilitate early detection of CHD, timely referrals and appropriate management.