Paediatric Echocardiography in Jos University Teaching Hospital: Problems, Prospects and Preliminary Audit

Background and Objectives: The pattern of paediatric heart diseases at the Jos University Teaching Hospital has not been described previously. The objective of this study was to document the pattern of heart diseases in children undergoing echocardiography at Jos University Teaching Hospital during an eight-month period and to identify the problems encountered. Patients and Methods: The indications and findings in 48 children undergoing routine trans thoracic echocardiography from December 1999 to July 2000 were retrospectively analyzed. The problems encountered were also noted. Results: The main indications for echocardiography were rheumatic heart disease (RHD) in 15 (31.5 percent), acyanotic congenital heart disease (CHD) in 10 (20.8 percent) and cyanotic CHD in six (12.5 percent) children. Others were evaluation of cardiac murmurs in six (12.5 percent), unexplained heart failure in three (6.3 percent), pericardial effusion in two (4.2 percent) and cardiac arrhythmia in two (4.2 percent). Significant abnormalities were found in 38 (79.2 percent) of the patients; these were congenital heart diseases in 16 (33.3 percent) and acquired heart diseases in 22 (45.8 percent). Ventricular septal defect (VSD) was an isolated lesion in six (37.5 percent) but was associated with other congenital lesions in nine others. Fallot tetralogy was the commonest cyanotic heart condition encountered. Doubling of cost during the second half of the period of review reduced the access of our patients to the investigation by one third. Excessive strain on the machine from overuse, multiple users and power fluctuations were identified as some of the factors that led to the breakdown of the equipment after only eight months. Conclusions: The pattern of paediatric heart disease in the hospital is similar to those reported from other parts of the country. The cost of paediatric echocardiography should be kept to a minimum, while the lifespan of the machine could be prolonged by restricting its use to echocardiography and vascular procedures and by the provision of stable power supply.