Cardiovascular Journal of Africa: Vol 32 No 1 (JANUARY/FEBRUARY 2021)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 1, January/February 2021 26 AFRICA
In recent studies, septal defects have been linked to maternal
exposure to particulate matter.24,25 This provides one more
reason to address the pressing matter of particulate air pollution
and it would be important in future studies to identify factors
that predispose to the development of CHD in our environment
so that recommendations can be made concerning possible
measures that could reduce their incidence.
Other CHD subtypes reported in this study also differed
when compared to other countries and the global prevalence,
and this could be as a result of the presence of relative causal
mechanisms of the different lesions and the mode of entry
of subjects into a study, as some lesions such as PS and CoA
may be asymptomatic at birth and may be missed during the
neonatal period.23 HLHS accounted for two-thirds of our cases
of critical CHD, which contrasts with reports from developed
countries where the prevalence of this defect has decreased
significantly, primarily due to prenatal echocardiography and
the termination of affected pregnancies.23,26
The present study provides a more accurate representation
of the prevalence of CHD in the country, compared to previous
studies, because it was conducted in neonates with a higher
likelihood of discovering critical CHD, which often results
in early neonatal mortality.27 In a recent nationwide registry
report, 14% of the 1 296 CHD cases were below one month of
age, and five cases of critical CHD were detected.28 The registry
subjects were children referred for cardiac evaluation and do not
represent the true prevalence of critical CHD and other lesions
detected.
Limitations are that this study was undertaken in only the
north-central part of the country and our data may not reflect
the burden of disease in other regions. Multicentre screening
studies involving other parts of the country are needed to
provide better estimates of the nationwide burden of CHD and
the differences in prevalence and spectrum between regions.
Conclusion
There is a high prevalence of CHD among neonates in Jos,
north-central Nigeria. Although most of the lesions detected
were mild, attention should be given to newborn screening
for CHD to mitigate morbidity and mortality from moderate
and severe lesions, especially in sick neonates and those born
to older women. Early identification of CHD is essential in
providing accurate data for advocacy in order to make affordable
paediatric cardiology and cardiac surgery services accessible to
children born with CHD in Nigeria.
Research reported in this publication was supported by the Fogarty
International Center (FIC), Office of the Director (OD/NIH), National
Institute of Neurological Disorders and Stroke (NINDS/NIH), and the
National Institute of Nursing Research (NINR/NIH) of the National
Institutes of Health under award number D43 TW010130. The content is
solely the responsibility of the authors and does not necessarily represent the
views of the National Institutes of Health.
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