Despite tremendous advances in the treatment of congenital heart disease (CHD), a new global study shows that the chances for a child to survive a CHD diagnosis are significantly less in low-income countries. The research revealed that nearly 12 million people are currently living with CHD globally, 18.7 percent more than in 1990.
The findings, published in The Lancet, are drawn from the first comprehensive study of congenital heart disease across 195 countries, prepared using data from the Global Burden of Diseases, Injuries and Risk Factors Study 2017 (GBD).
"Previous congenital heart estimates came from few data sources, were geographically narrow and did not evaluate CHD throughout the life course," said the study authors from Children's National Hospital in the US.
A decline in deaths between 1990 to 2017
This is the first time the GBD study data was used along with all available data sources and previous publications - making it the most comprehensive study on the congenital heart disease burden to date.
The study found a 34.5 percent decline in deaths from the congenital disease between 1990 to 2017. Nearly 70 percent of deaths caused by CHD in 2017 (180,624) were in infants less than one year old. Most CHD deaths occurred in countries within the low and low-middle socio-demographic index (SDI) quintiles.
Mortality rates get lower as a country's Socio-demographic Index (SDI) rises, the study said. According to the researchers, the birth prevalence of CHD was not related to a country's socio-demographic status, but the overall prevalence was much lower in the poorest countries of the world.
Target to reduce preventable deaths of newborns and children
This is because children in these countries do not have access to life-saving surgical services, they added. "In high-income countries like the United States, we diagnose some heart conditions prenatally during the 20-week ultrasound," said Gerard Martin from Children's National Hospital who contributed to the study.
"For children born in middle- and low-income countries, these data draw stark attention to what we as cardiologists already knew from our own work in these countries -- the lack of diagnostic and treatment tools leads to lower survival rates for children born with CHD," said researcher Craig Sable.
"The UN has prioritised reduction of premature deaths from heart disease, but to meet the target of 'ending preventable deaths of newborns and children under 5 years of age,' health policymakers will need to develop specific accountability measures that address barriers and improve access to care and treatment," the authors wrote.