Clinical spectrum and prevalence of congenital heart disease in children in Botswana.

BACKGROUND: Reliable data on congenital heart disease (CHD) from diverse settings is important both for planning health systems in each country and to elucidate possible aetiologies of CHD in different settings. There is a lack of data on the clinical spectrum and prevalence of CHD in Botswana. The aim of this study was to describe the clinical spectrum and prevalence of CHD in Botswana. METHODS: This was a retrospective, descriptive, cross-sectional study of all children from birth to 15 years who had had an echocardiogram performed as an in- or out-patient at Princess Marina Hospital (PMH) between 1 January 2010 and 31 December 2012. RESULTS: Of 377 enrollees, 140 (40%) had normal echocardiographs, 170 (45%) had CHD, and 57 (15%) had an acquired lesion. In the CHD patients, median age was 0.9 years (Q1: 0.2, Q3: 4.1) and 85 (50%) were male. Ventricular septal defect (VSD) (29%), patent ductus arteriosus (18%), atrio-ventricular septal defect (AVSD) (10%) and tetralogy of Fallot (TOF) (6%) were the predominant pathologies. VSD was the most common acyanotic lesion and TOF the most common cyanotic lesion. The estimated prevalence of CHD was between 2.8 and 4.95 per 1 000 live births. CONCLUSIONS: The clinical spectrum of CHD in Botswana is similar to that observed in other African countries and in the Western world, with VSD the most common acyanotic lesion and TOF the most common cyanotic lesion. The prevalence of CHD was 2.8-4.95 per 1 000 live births, in keeping with other settings. This is the first study to describe CHD in Botswana, and it aimed to stimulate subsequent studies in this field.