What do you know about paediatric heart disease?
Sunday, July 29, 2018

Jacqueline Mukanyarwanya gave birth to a seemingly healthy baby boy; however, during vaccination when he was three and a half month’s old, medics were concerned about his loss of weight.

"The baby had some issues like diarrhoea and incessant cough,” Mukanyarwanya says.

She took him to a couple of healthcare centres but nothing changed, despite efforts made to help him.

"I went to Jali Health Centre which is close to where I live, then I took him to other neighbouring centres but I didn’t see any results. Finally, I was referred to Kibagabaga Hospital and they told me it was a lung problem. I was given medicine but his health didn’t improve,” she says.

She was then referred to Kanombe Military Hospital, where the baby was diagnosed with congenital heart disease.

They then sent her to University Teaching Hospital of Kigali (CHUK) where the baby started receiving medical attention.

"When he started taking medication at CHUK, the cough and diarrhoea stopped. Even though these conditions occur from time-to-time, he looks much healthier,” she says. 

Mukanyarwaya’s baby is among the 20 Rwandan children suffering from severe heart diseases who are going to Israel to undergo heart surgery, on the partnership of the Ministry of Health and Save a Child’s Heart Foundation.

The Save a Child’s Heart team will screen 70 children at Kigali Teaching Hospital, 20 among them with severe cases will be immediately transferred to Israel with all costs covered.

The foundation is an Israeli non-government organisation with the mission of improving the quality of paediatric cardiac care for children in developing countries and creating centres of competence in this part of the world.

Emmanuel Rusingiza, a paediatric specialising on children with heart diseases, says many children with cardiac problems were born with them.

"It means that the heart was not formed well. There is no tangible cause for this problem, albeit a few proven factors may pose risks to the foetus,” he says.

Heart disease in babies and children is quite different from that in adults.

In adults, the risk can be increased by uncontrolled food consumption and unhealthy behaviours like drinking alcohol and smoking, he says.

Dr Evariste Ntaganda, in charge of the heart diseases department at Rwanda Biomedical Centre (RBC), says babies can suffer from acquired heart diseases or rheumatic heart diseases mostly from untreated pharyngitis (angina), a symptom of coronary artery disease.

Angina creates complications which may cause various types of cardiac disease among children and adults, he says.

"Most people, especially in rural areas, treat angina traditionally, and they are never cured which later creates complications of the heart,” Ntaganda says.

SYMPTOMS

Dr Rusingiza says congenital heart disease symptoms occur after birth, or after a few weeks. When a baby is born with severe heart disease, the skin has a strange blue-ish colour.

In that case, he/she needs special care.  In others, symptoms can take up to three weeks or even a month, he says.

Breathing rapidly, sweating when feeding, tiredness when breastfeeding causing a decrease in weight, are among the symptoms of congenital heart disease, he says.

EARLY DIAGNOSIS

Dr Rusingiza says when babies are diagnosed early, the chances of getting treatment and healing are high.

In countries that have advanced medical technology, they can detect any heart problem even at 12 weeks of pregnancy with antenatal diagnosis, and if they find anything, they recommend that the mother gives birth in a well-equipped hospital so that they conduct heart surgery after birth.

"We don’t have this technology yet, but as the health sector develops, it’s good for parents to take their babies to hospitals the minute they notice any symptoms. The earlier, the better,” Rusingiza says.

"For those who are found to have complications, we search for all possible opportunities for them to be operated abroad, or we put them on a list in case a team of charitable doctors comes to Rwanda for heart disease surgery. One big issue we have is that children are brought here when their cases are so severe and we can’t save them. For example, from the list we made and sent to the Israeli doctors, in just a short period, 12 of those babies died. It’s better to come early,” he adds. Also, stopping treatment when a child shows signs of improvement should not happen as it doesn’t give proper resistance to bacteria that later results in stronger complications, he says.

editorial@newtimes.co.rw