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Improving Early Detection and Treatment of Congenital Heart Disease in Tanzanian Children: An Evidence - Based Perspective

Congenital heart disease (CHD) is a leading cause of illness and death among children worldwide, often going undetected in many African countries until it is too late. This PhD research focused on the burden of CHD among children in Tanzania, East Africa, examining how it is detected and managed, as well as the impact of early interventions.

The study involved reviewing thousands of heart cases, assessing surgical outcomes, and evaluating the quality of life of affected children from 2019 to 2024. Findings revealed that late diagnoses often lead to worse health outcomes and higher treatment costs. Conversely, children who received early diagnosis and surgery had significantly improved survival rates and quality of life. The study suggested possible associations between CHD and factors like older maternal age (over 40 years), maternal diabetes, and a family history of CHD. A crucial part of the research examined pulse oximetry (POX), a simple and affordable tool for screening newborns for heart disease. Many developed countries have mandated POX screening within 24 to 48 hours after birth since the early 2000s.

In the Netherlands, where advanced fatal heart scans are common, POX plays a smaller role. However, in Tanzania, POX presents a critical opportunity despite systemic barriers to its implementation. The research confirmed that POX screening is feasible, accurate, and cost-effective in Tanzania, saving the health system twenty dollars for every dollar invested. These findings suggest that Tanzania can implement newborn heart screening, improve survival rates, and potentially serve as a model for the region.