CARDIOVASCULAR JOURNAL OF AFRICA • Kenya Cardiac Society July 2023 11 AFRICA Presence of a cardiac murmur (OR = 0.87; 95% CI 0.72–0.92, p-value = 0.016) and level of parental education (OR = 4.99; 95% CI 2.25–11.40, p-value <0001) were associated with a decreased odds of late diagnosis. Other factors like cyanosis, an increase in the number of healthcare workers and healthcare facilities per 10,000 population showed some association with decreased odds of late diagnosis of CHD, but these were not statistically significant. Conclusion Late diagnosis of CHD remains alarmingly high in our setting. Initiatives to enhance early detection and screening of CHD should be adopted to reduce related mortality and morbidity. Submission ID: 10 FOCUSED CARDIAC ULTRASOUND: COMPETENCY AMONG MEDICAL OFFICER TRAINEES IN DIFFERENTIATING CARDIOVASCULAR CAUSES OF DYSPNOEA MURIUKI D.M., JOSHI M. D., KAGIMA J.W., JOEKES E., KWASA T.O. Background Differentiation of cardiovascular causes of acute dyspnea in resource-limited healthcare settings can be challenging. Diagnostics such as Brain Natriuretic Peptide (BNP) and echocardiography are Submission ID: 11 PEDIATRIC CARDIAC DISEASE BURDEN AS SEEN AT COAST GENRAL TEACHING AND REFRRAL HOSPITAL ZENAB MUBARAK, BAKARI SULEIMAN MWASHAMBI, ZENAB THABIT MBARAK Background The burden of paediatric cardiac disease is immense in Africa and it’s the second leading cause of death of children in the first year of life. Despite the advancement in technology that has improved the outcomes of children with cardiac disease in developed countries, Africa still lags behind and little is known on the outcomes of these children. There is little research work done on the topics of both congenital and acquired diseases especially in sub-Saharan Africa whereby most of the population is marginalised. Several factors have been identified in previous research as financial challenges and lack of access to quality health care being the main reasons. As little effort has been done to improve the outcome, the burden of disease is growing and carries important implications on the future of the children and families in these regions. Methods A total of 10 free echo screening outreach camps were conducted in 8 marginalised areas in Kenya. The camps were conducted within often unavailable. The use of Focused Cardiac Ultrasound (FoCUS) protocols may potentially alleviate these challenges. The Cardiac Ultrasound for Resource-limited Settings (CURLS) protocol is nonvalidated, context specific, easy to train Sub-Xiphoid single window FoCUS tool. We sought to assess trainee competence in evaluating cardiovascular causes of dyspnea using CURLS after a brief training in three domains: Image Interpretation, Image Acquisition, and Image Quality Methods This was a quasi-experimental study conducted at a public tertiary hospital. Forty-five medical pre-interns, novices in echocardiography, underwent simulated didactic and hands-on FoCUS skills training using the CURLS protocol and their skills were assessed. Image Interpretation was assessed using a standardized case-based MCQ test. Image Acquisition Skills were assessed using an OSCE checklist. Image Quality was graded by two FoCUS experts using the 2018 ACEP 5 Point Image Quality Assurance Grading Scale. Data analysis involved computing trainee scores in the 3 domains using ranges, means, medians and 95% confidence intervals. Proportions of trainees who attained competence were expressed in percentages. Results Aggregate image interpretation competency was attained by n=38 (84 %) of trainees with a median score of 80%. The proportion of trainees attaining category-specific image interpretation competency was: Pericardial Effusion n=44 (98%), Left Atrial Enlargement n= 40 (89%), Cardiomyopathy n=38 (84%), Left Ventricular Hypertrophy n=37 (82%), and Right Ventricular Enlargement n=29 (64%). Image Acquisition Skills Competency was attained by n=36 (80%) of trainees with a median score of 82 %. The two experts were in agreement that 77% of trainee-obtained images were of good quality. Conclusions The majority of trainees in our study attained competency in FoCUS skills after training with the CURLS protocol. The simplicity, ease of training and use of the CURLS protocol make it an ideal FoCUS screening tool for training healthcare personnel to use at the point of care in resource-limited settings. The training conditions and participant selection bias limit the generalizability of our results. 1. Huson MAM, Kaiminstein D, Heller T. The Ultrasound Journal. 2019;(11:34) 2. Neskovic AN, Skinner H, Price S, Via G. European Heart Journal. 2018 January;(19): 475-481. 3. American College of Emergency Physicians. acep. [Online].; 2018
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