article · Tanzania journal of health research/Tanzania Journal of Health Research
Congenital heart disease is a leading cause of illness and death among children, requiring early and accurate diagnosis to guide clinical intervention. A retrospective study examined 113 paediatric patients aged 11 months to 17 years at Muhimbili National Hospital who had previous diagnoses via echocardiography. Ventricular septal defects represented the most frequent condition observed, while fatigue and rapid breathing were the primary symptoms. While echocardiography and cardiac computed tomography showed strong correlation for defects such as ventricular, patent ductus arteriosus, and atrial septal defects, computed tomography proved significantly superior in delineating complex structural anatomy. Specifically, computed tomography outperformed echocardiography in evaluating features of Tetralogy of Fallot, including right ventricular hypertrophy, overriding aorta, and infundibular stenosis, providing critical anatomical detail necessary for patient management.
Detecting complex congenital heart defects accurately is essential for planning life-saving surgical and clinical interventions in young children. Demonstrating that cardiac computed tomography resolves complex anatomy more effectively than standard echocardiography provides hospitals with clear evidence to refine diagnostic pathways, potentially improving paediatric outcomes in resource-constrained health systems.
The findings support the clinical adoption of cardiac computed tomography scanning protocols in paediatric cardiology departments and diagnostic imaging centres. As an applied clinical study validating existing hospital equipment, it informs clinical guidelines and referral pathways rather than a novel commercial product. The abstract does not indicate a commercialisation pathway.
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Background: Congenital heart defects are an important cause of morbidity and mortality in pediatric age. The prevalence in Tanzania and Africa is 8% and 31.3% respectively. Various congenital heart defects have been described in the literature, the commonest being a ventricular septal defect (VSD). Early diagnosis of these conditions is important for better outcomes. This study aimed to elucidate the value of Cardiac CT in pediatric patients diagnosed with congenital Heart Disease (CHD). Methodology: We enrolled 113 pediatric patients previously diagnosed with CHD by echocardiography (ECHO) in a six-month retrospective study at Muhimbili National Hospital. A structured questionnaire recorded patient demographic data, clinical information, and Computed Tomography (CT) findings. A statistical package for social sciences version 20 was applied for data analysis. A chi-square and t-test were obtained for establishing a statistical association of p-value of < 0.05 at a 95% confidence interval. Results: Enrolled children's ages ranged from 11 months to 17 years. Tachypnea 19(16.8%) and fatigue 65(57.5%) were the commonest clinical findings among infants and children, respectively. The common cardiac anomaly was VSD 45(39.8%), characterized by cardiomegaly 46 (36.2%) among pediatric patients who underwent CT. Age below five years was the common risk factor associated with VSD, PDA, and ASD (p=0.001). Shortness of breath was the most common clinical condition associated with CHD patients with ASD and TOF (p=0.001). Maternal risk factors such as college education 17(42.5%) and cesarean-section delivery 16 (41.0%) were strongly associated with having a PDA anomaly (p=0.001). Diabetic mothers (78.6%) were identified to have an association with having babies with TOF anomaly (p=0.04). ECHO findings in VSD, PDA, and ASD were strongly correlated with CT findings at 39(86.7%), 19(70.4%), and 23(74.2%), respectively, with a p-value of 0.001. CT was statistically significantly superior to echocardiography in the evaluation of TOF characteristics such as right ventricular hypertrophy (k=0.9), infundibular stenosis (k=0.3), and overriding aorta (k=0.4), p value of 0.001. Conclusion:. VSD is the most common congenital cardiac defect in our setting. CT is an ideal modality for detecting complex cardiovascular anatomy that may be limited in access to echocardiography. All patients suspected of having CHD should undergo a CT scan for detailed anatomic review that will guide management.
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DOI: 10.4314/thrb.v26i6.8
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