Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China.
School of Public Health, Kunming Medical University, Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, China.
BMC Cardiovasc Disord. 2023 Jun 7;23(1):288. doi: 10.1186/s12872-023-03314-8.
Congenital heart disease (CHD) is the leading cause of mortality in childhood worldwide. However, a large number of children with CHD are not diagnosed promptly in low- and middle-income regions, due to limited healthcare resources and lack the ability of prenatal and postnatal ultrasound examinations. The research on asymptomatic CHD in the community is still blank, resulting in a large number of children with asymptomatic CHD can not be found and treated in time. Through the China-Cambodia collaborative health care initiative, the project team conducted research, screened children's CHD through a sampling survey in China and Cambodia, collected relevant data, and retrospectively analyzed the data of all eligible patients.
The project aimed to evaluate the prevalence of asymptomatic CHD in a sample population of 3-18years old and effects on their growth status and treatment outcomes.
We examined the prevalence of 'asymptomatic CHD' among 3-18years old children and adolescents at the township/county levels in the two participating. A total of eight provinces in China and five provinces in Cambodia were analyzed from 2017 to 2020. During 1 year follow-up after treatment, the differences in heights and weights of the treated and control groups were evaluated.
Among the 3,068,075 participants screened from 2017 to 2020, 3967 patients with asymptomatic CHD requiring treatment were identified [0.130%, 95% confidence interval (CI) 0.126 -0.134%]. The prevalence rate of CHD ranged from 0.02 to 0.88%, and was negatively related to local per capita GDP (p = 0.028). The average height of 3310 treated CHD patients were 2.23% (95% CI: -2.51%-1.9%) lower than that of the standard group and the average weight was - 6.41% (95% CI: -7.17%-5.65%) lower, the developmental gap widening with advancing age. One year after treatment, the relative height difference remained comparable while that, in weight was reduced by 5.68% (95% CI: 4.27% ~7.09%).
Asymptomatic CHD now is often overlooked and is an emerging public health challenge. Early detection and treatment are essential to lower the potential burden of heart diseases in children and adolescents.
先天性心脏病（CHD）是全球儿童死亡的主要原因。然而，由于医疗资源有限且缺乏产前和产后超声检查能力，许多中低收入地区的儿童未能及时得到诊断。社区无症状 CHD 的研究仍属空白，导致大量无症状 CHD 患儿无法及时发现和治疗。通过中柬医疗合作倡议，项目团队在中国和柬埔寨开展了抽样调查研究，筛查儿童 CHD，收集相关数据，并对所有符合条件的患者数据进行回顾性分析。
评估 3-18 岁样本人群中无症状 CHD 的患病率，并评估其对生长状况和治疗结果的影响。
我们在两个参与国的乡镇/县级水平检查了 3-18 岁儿童和青少年中“无症状 CHD”的患病率。对 2017 年至 2020 年期间中国的八个省份和柬埔寨的五个省份进行了分析。在治疗后 1 年的随访期间，评估治疗组和对照组的身高和体重差异。
在 2017 年至 2020 年筛查的 3068075 名参与者中，发现 3967 名需要治疗的无症状 CHD 患者[0.130%，95%置信区间（CI）0.126-0.134%]。CHD 的患病率范围为 0.02-0.88%，与当地人均 GDP 呈负相关（p=0.028）。3310 名接受治疗的 CHD 患者的平均身高比标准组低 2.23%（95%CI：-2.51%-1.9%），平均体重低 6.41%（95%CI：-7.17%-5.65%），随着年龄的增长，发育差距逐渐扩大。治疗 1 年后，相对身高差异仍相当，而体重则降低了 5.68%（95%CI：4.27%-7.09%）。
无症状 CHD 现在经常被忽视，是一个新出现的公共卫生挑战。早期发现和治疗对于降低儿童和青少年心脏病的潜在负担至关重要。
