Surgical outcomes of congenital heart disease in African pediatric populations: a systematic review

Abstract Background Congenital heart disease (CHD) is a major cause of child morbidity and mortality across Africa. Despite increased recognition of CHD as a significant public health challenge, surgical services remain geographically and institutionally limited. Individual reports and studies have shown widely varied surgical outcomes for pediatrics in Africa. Hence, there is a need to obtain consolidated evidence on these outcomes to guide policies. This study systematically analyzes the surgical outcomes of CHD among African pediatric populations. Method Using the PRISMA guidelines, we searched databases including PubMed, Google Scholar, Scopus, Web of Science, and AJOL. Boolean operators (AND, OR) were used appropriately to combine the keywords. We then screened articles for eligibility, ensuring that only studies with surgical interventions comprising the pediatric African population were selected. Results A total of 2,843 records were screened, of which 18 eligible studies were included. The median age of the included population ranged from about 2 years to 15 years. The postoperative mortality ranged from approximately 0% to 13%. In many cases, patients presented late, often with advanced disease and comorbidities. The median hospital stay ranged from 7 to 19 days. Centers with locally trained cardiac surgeons had better survival rates than those reliant solely on visiting international missions. Conclusion There are wide systemic inequities in terms of the availability of surgical services and outcome measures such as mortality and complications. There is a need to invest adequately in pediatric cardiac programs to ensure the availability of highly-skilled local cardiologists and adequate infrastructure.