Pattern and Outcome of Congenital Heart Diseases at the Emergency Paediatric Unit of a Tertiary Hospital in Azare, North-Eastern Nigeria

Abstract

Background: Congenital heart diseases (CHD) significantly impact childhood health in low-resource settings. This study aimed to assess the hospital-based proportion, clinical patterns, complications, and outcomes of CHD among children seen at the Emergency Paediatric Unit of the Federal University of Health Sciences Teaching Hospital, Azare, North-Eastern Nigeria, over one year.

Materials and Methods: A retrospective analysis was conducted on children aged 1 month to 15 years with echocardiographically confirmed CHD from January 1 to December 31, 2024. Data were collected from medical records and analysed using IBM SPSS version 25. Binary logistic regression identified mortality predictors, with statistical significance set at p<0.05.

Results: Of 2,973 admissions, 42 (1.41%) had confirmed CHD. Median presentation age was 9 months (IQR: 3-26), with male predominance (1.2:1). Commonest lesions included ventricular septal defect (33.3%), tetralogy of Fallot (21.4%), and patent ductus arteriosus (14.3%). Complications featured heart failure (50.0%), severe pneumonia (31.0%), and hypoxic spells (14.3%). Overall mortality was 35.7% (15/42), with 80% of deaths in infants. Only 7.1% accessed a surgical referral. Independent mortality predictors were age <6 months (AOR: 3.41, 95%CI: 1.38-8.42, p=0.008), delayed presentation (AOR: 2.89, 95%CI: 1.18-7.06, p=0.021), heart failure at presentation (AOR: 3.92, 95%CI: 1.54-9.97, p=0.004), complex CHD (AOR: 4.56, 95%CI: 1.72-12.08, p=0.002), and lack of surgical referral (AOR: 7.23, 95%CI: 1.51-34.62, p=0.013).

Conclusions: CHD significantly contributes to paediatric morbidity and mortality in this region. Many infants present late and face substantial barriers to surgical care. Enhancing early detection and improving access to cardiac services are essential to reducing mortality.

Keywords: Congenital heart disease, morbidity, mortality, emergency unit, Nigeria, Sub-Saharan Africa