{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/29683"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/29683","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project","abstract":"Introduction: Congenital and acquired heart diseases are highly prevalent in developing countries despite limited specialised care. Namibia established a paediatric cardiac service in 2009 with significant human resource and infrastructural constraints. Therefore, patients are referred for cardiac interventions to South Africa. Objectives: To describe the diagnoses, clinical characteristics, interventions, post-operative morbidity and mortality and follow-up of patients referred for care. Methods: Demographics, diagnoses, interventions, intra- and postoperative morbidity and mortality as well as longitudinal follow-up data of all patients referred to South Africa were recorded and analysed. Results: The total cohort constituted 193 patients of which 179 (93%) had congenital and 7% acquired heart disease. The majority of patients (78.8%) travelled more than 400 km to Windhoek prior to transfer. There were 28 percutaneous interventions. Palliative and definitive surgery was performed in 27 and 129 patients respectively. Eighty (80/156, 51.3%) patients had postoperative complications, of which 15 (9.6%) were a direct complication of surgery. Surgical mortality was 8/156 (5.1%, 95% confidence interval 1.2.2-9.8), with a 30- day mortality of 3.2%. Prolonged ICU stay was associated with a 5% increased risk of death (Hazard Ratio 1.05, 95% confidence interval: 1.02-1.08, p=0.001). Follow-up was complete in 151 (78%) patients over seven years. Conclusions: Despite the challenges associated with a cardiac programme referring patients for intervention to a neighbouring country and the adverse characteristics of multiple lesions and complexity associated with late presentation, we report good surgical and interventional outcomes. Our goal remains to develop a comprehensive sustainable cardiac service in Namibia.","abstract_html":"Introduction: Congenital and acquired heart diseases are highly prevalent in developing countries despite limited specialised care. Namibia established a paediatric cardiac service in 2009 with significant human resource and infrastructural constraints. Therefore, patients are referred for cardiac interventions to South Africa. Objectives: To describe the diagnoses, clinical characteristics, interventions, post-operative morbidity and mortality and follow-up of patients referred for care. Methods: Demographics, diagnoses, interventions, intra- and postoperative morbidity and mortality as well as longitudinal follow-up data of all patients referred to South Africa were recorded and analysed. Results: The total cohort constituted 193 patients of which 179 (93%) had congenital and 7% acquired heart disease. The majority of patients (78.8%) travelled more than 400 km to Windhoek prior to transfer. There were 28 percutaneous interventions. Palliative and definitive surgery was performed in 27 and 129 patients respectively. Eighty (80/156, 51.3%) patients had postoperative complications, of which 15 (9.6%) were a direct complication of surgery. Surgical mortality was 8/156 (5.1%, 95% confidence interval 1.2.2-9.8), with a 30- day mortality of 3.2%. Prolonged ICU stay was associated with a 5% increased risk of death (Hazard Ratio 1.05, 95% confidence interval: 1.02-1.08, p=0.001). Follow-up was complete in 151 (78%) patients over seven years. Conclusions: Despite the challenges associated with a cardiac programme referring patients for intervention to a neighbouring country and the adverse characteristics of multiple lesions and complexity associated with late presentation, we report good surgical and interventional outcomes. Our goal remains to develop a comprehensive sustainable cardiac service in Namibia.","abstract_has_math":false,"creators":["Shidhika, Fenny Fiindje"],"institution":"Department of Paediatrics and Child Health","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Zühlke, Liesl Joanna","Hugo-Hamman, Christopher"],"committee_chairs":[],"committee_members":[],"year":2018,"date_issued":"2018","date_published":"2018","updated_at":"2026-07-22T22:23:31Z","subjects":[],"languages":["eng"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/29683","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Zühlke, Liesl Joanna","Hugo-Hamman, Christopher"]},{"key":"dc:creator","label":"Author","values":["Shidhika, Fenny Fiindje"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2019-02-19T13:35:25Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2019-02-19T13:35:25Z"]},{"key":"dc:date.issued","label":"Date","values":["2018"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Paediatrics and Child Health"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["University of Cape Town"]},{"key":"dc:type","label":"Dc Type","values":["Master Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["MPhil"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["eng"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/29683"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Introduction: Congenital and acquired heart diseases are highly prevalent in developing countries despite limited specialised care. Namibia established a paediatric cardiac service in 2009 with significant human resource and infrastructural constraints. Therefore, patients are referred for cardiac interventions to South Africa. Objectives: To describe the diagnoses, clinical characteristics, interventions, post-operative morbidity and mortality and follow-up of patients referred for care. Methods: Demographics, diagnoses, interventions, intra- and postoperative morbidity and mortality as well as longitudinal follow-up data of all patients referred to South Africa were recorded and analysed. Results: The total cohort constituted 193 patients of which 179 (93%) had congenital and 7% acquired heart disease. The majority of patients (78.8%) travelled more than 400 km to Windhoek prior to transfer. There were 28 percutaneous interventions. Palliative and definitive surgery was performed in 27 and 129 patients respectively. Eighty (80/156, 51.3%) patients had postoperative complications, of which 15 (9.6%) were a direct complication of surgery. Surgical mortality was 8/156 (5.1%, 95% confidence interval 1.2.2-9.8), with a 30- day mortality of 3.2%. Prolonged ICU stay was associated with a 5% increased risk of death (Hazard Ratio 1.05, 95% confidence interval: 1.02-1.08, p=0.001). Follow-up was complete in 151 (78%) patients over seven years. Conclusions: Despite the challenges associated with a cardiac programme referring patients for intervention to a neighbouring country and the adverse characteristics of multiple lesions and complexity associated with late presentation, we report good surgical and interventional outcomes. Our goal remains to develop a comprehensive sustainable cardiac service in Namibia."]},{"key":"dc:title","label":"Title","values":["The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project"]}]}],"canonical_facts":{"dc:contributor.advisor":["Zühlke, Liesl Joanna","Hugo-Hamman, Christopher"],"dc:creator":["Shidhika, Fenny Fiindje"],"dc:date.accessioned":["2019-02-19T13:35:25Z"],"dc:date.available":["2019-02-19T13:35:25Z"],"dc:date.issued":["2018"],"dc:description.abstract":["Introduction: Congenital and acquired heart diseases are highly prevalent in developing countries despite limited specialised care. Namibia established a paediatric cardiac service in 2009 with significant human resource and infrastructural constraints. Therefore, patients are referred for cardiac interventions to South Africa. Objectives: To describe the diagnoses, clinical characteristics, interventions, post-operative morbidity and mortality and follow-up of patients referred for care. Methods: Demographics, diagnoses, interventions, intra- and postoperative morbidity and mortality as well as longitudinal follow-up data of all patients referred to South Africa were recorded and analysed. Results: The total cohort constituted 193 patients of which 179 (93%) had congenital and 7% acquired heart disease. The majority of patients (78.8%) travelled more than 400 km to Windhoek prior to transfer. There were 28 percutaneous interventions. Palliative and definitive surgery was performed in 27 and 129 patients respectively. Eighty (80/156, 51.3%) patients had postoperative complications, of which 15 (9.6%) were a direct complication of surgery. Surgical mortality was 8/156 (5.1%, 95% confidence interval 1.2.2-9.8), with a 30- day mortality of 3.2%. Prolonged ICU stay was associated with a 5% increased risk of death (Hazard Ratio 1.05, 95% confidence interval: 1.02-1.08, p=0.001). Follow-up was complete in 151 (78%) patients over seven years. Conclusions: Despite the challenges associated with a cardiac programme referring patients for intervention to a neighbouring country and the adverse characteristics of multiple lesions and complexity associated with late presentation, we report good surgical and interventional outcomes. Our goal remains to develop a comprehensive sustainable cardiac service in Namibia."],"dc:identifier.uri":["http://hdl.handle.net/11427/29683"],"dc:language.iso":["eng"],"dc:publisher.department":["Department of Paediatrics and Child Health"],"dc:publisher.institution":["University of Cape Town"],"dc:title":["The South-South partnership to provide cardiac surgery: The Namibian Children Heart Project"],"dc:type":["Master Thesis"],"dc:type.qualificationlevel":["Masters"],"dc:type.qualificationname":["MPhil"]},"updated_at":"2026-07-22T22:23:31Z"}