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Screening for Critical Congenital Heart Disease in Developing Countries
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Screening for Critical Congenital Heart Disease in Developing Countries

A special issue of International Journal of Neonatal Screening (ISSN 2409-515X).

Deadline for manuscript submissions: closed (28 February 2020) | Viewed by 19223

Special Issue Editors

Dr. Gerard R. Martin

E-Mail Website
Guest Editor
Children’s National Heart Institute, Washington, DC 20010-2970, USA
Interests: critical congenital heart disease; newborn pulse oximetry screening
Ms. Lisa A. Wandler

E-Mail Website
Guest Editor
Children’s National Heart Institute, Washington, DC 20010-2970, USA
Interests: critical congenital heart disease screening; pediatric quality and safety

Special Issue Information

Dear Colleagues,

Screening for critical congenital heart disease using pulse oximetry is becoming a standard point of care newborn screen in many developed countries. The benefits and challenges of this newborn screen are unique in other parts of the world where secondary targets and infrastructure development have grown in importance. This Special Issue explores some of these unique challenges and benefits.

Dr. Gerard R. Martin
Ms. Lisa A. Wandler
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Neonatal Screening is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • CCHD screening using pulse oximetry
  • newborn critical congenital heart screening
  • pulse oximetry developing countries

Published Papers (5 papers)

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Editorial

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5 pages, 465 KiB  
Editorial
Newborn Critical Congenital Heart Disease Screening Using Pulse Oximetry: Value and Unique Challenges in Developing Regions
by Lisa A. Hom and Gerard R. Martin
Int. J. Neonatal Screen. 2020, 6(3), 74; https://doi.org/10.3390/ijns6030074 - 15 Sep 2020
Cited by 3 | Viewed by 2678
Abstract
Newborn screening for critical congenital heart disease (CCHD) is recommended for implementation in many developed countries as the standard of care. Efforts to implement this point of care screen in developing regions face unique barriers, and present important opportunities. The First Pan-African Newborn [...] Read more.
Newborn screening for critical congenital heart disease (CCHD) is recommended for implementation in many developed countries as the standard of care. Efforts to implement this point of care screen in developing regions face unique barriers, and present important opportunities. The First Pan-African Newborn Screening Conference, held in Rabat in June 2019, incorporated a workshop dedicated specifically to identifying and discussing CCHD screening issues in the Middle East Northern Africa (MENA) region. The issues explored may be beneficial as part of the greater discussion of CCHD screening’s growing importance in developing regions around the world. Screening experts presented education and lessons learned from previous CCHD implementations, including a hands-on technical demonstration of CCHD screening. Children’s HeartLink, The Newborn Foundation, and Children’s National Hospital each presented on their experiences working with teams and pilot projects from around the world. Experience in implementation from Children’s Hospital Marrakesh was presented and highlighted some of the unique findings, challenges, and experiences of screening in Morocco. As developing regions investigate the implementation of CCHD screening using pulse oximetry either as part of research studies, pilots, regional studies, or as part of a nationally supported program, data to inform policymakers on the benefits of screening and specific needs for infrastructure development and resources are essential. This special issue contains initial lessons learned on newborn CCHD screening from a select number of developing countries, including Saudi Arabia and Morocco and regions such as Latin America. Full article
(This article belongs to the Special Issue Screening for Critical Congenital Heart Disease in Developing Countries)
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Research

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7 pages, 339 KiB  
Article
Pulse Oximetry and Congenital Heart Disease Screening: Results of the First Pilot Study in Morocco
by Nadia El Idrissi Slitine, Fatiha Bennaoui, Craig A. Sable, Gerard R. Martin, Lisa A. Hom, Amal Fadel, Soufiane Moussaoui, Nadir Inajjarne, Drissi Boumzebra, Youssef Mouaffak, Said Younous, Lahcen Boukhanni and Fadl Mrabih Rabou Maoulainine
Int. J. Neonatal Screen. 2020, 6(3), 53; https://doi.org/10.3390/ijns6030053 - 30 Jun 2020
Cited by 10 | Viewed by 4419
Abstract
Congenital heart disease (CHD) is the most common congenital malformation. Diagnosis of critical congenital heart disease (CCHD), the most severe type of congenital heart disease, in a newborn may be difficult. The addition of CCHD screening, using pulse oximetry, to clinical assessment significantly [...] Read more.
Congenital heart disease (CHD) is the most common congenital malformation. Diagnosis of critical congenital heart disease (CCHD), the most severe type of congenital heart disease, in a newborn may be difficult. The addition of CCHD screening, using pulse oximetry, to clinical assessment significantly improves the rate of detection. We conducted a pilot study in Morocco on screening neonates for critical congenital heart disease. This study was conducted in the maternity ward of Mohammed VI University Hospital of Marrakesh, Morocco, and included asymptomatic newborns delivered between March 2019 and January 2020. The screening of CCHD was performed by pulse oximetry measuring the pre- and post-ductal saturation. Screening was performed on 8013/10,451 (76.7%) asymptomatic newborns. According to the algorithm, 7998 cases passed the screening test (99.82%), including one inconclusive test that was repeated an hour later and was normal. Fifteen newborns failed the screening test (0.18%): five CCHD, five false positives, and five CHD but non-critical. One false negative case was diagnosed at 2 months of age. Our results encourage us to strengthen screening for CCHD by adding pulse oximetry to the routine newborn screening panel. Full article
(This article belongs to the Special Issue Screening for Critical Congenital Heart Disease in Developing Countries)
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Review

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26 pages, 338 KiB  
Review
CCHD Screening Implementation Efforts in Latin American Countries by the Ibero American Society of Neonatology (SIBEN)
by Augusto Sola, Susana Rodríguez, Alejandro Young, Lourdes Lemus Varela, Ramón Mir Villamayor, Marcelo Cardetti, Jorge Pleitez Navarrete, María Verónica Favareto, Victoria Lima, Hernando Baquero, Lorena Velandia Forero, María Elena Venegas, Carmen Davila, Fernando Dominguez Dieppa, Taína Malena Germosén, Ada Nidia Oviedo Barrantes, Ana Lorena Alvarez Castañeda, Mónica Morgues, Aldana Avila, Diana Fariña, Jose Luis Oliva, Erika Sosa and Sergio Golombekadd Show full author list remove Hide full author list
Int. J. Neonatal Screen. 2020, 6(1), 21; https://doi.org/10.3390/ijns6010021 - 14 Mar 2020
Cited by 10 | Viewed by 4081
Abstract
Congenital heart disease (CHD) is among the four most common causes of infant mortality in Latin America. Pulse oximetry screening (POS) is useful for early diagnosis and improved outcomes of critical CHD. Here, we describe POS implementation efforts in Latin American countries guided [...] Read more.
Congenital heart disease (CHD) is among the four most common causes of infant mortality in Latin America. Pulse oximetry screening (POS) is useful for early diagnosis and improved outcomes of critical CHD. Here, we describe POS implementation efforts in Latin American countries guided and/or coordinated by the Ibero American Society of Neonatology (SIBEN), as well as the unique challenges that are faced for universal implementation. SIBEN collaborates to improve the neonatal quality of care and outcomes. A few years ago, a Clinical Consensus on POS was finalized. Since then, we have participated in 12 Latin American countries to educate neonatal nurses and neonatologists on POS and to help with its implementation. The findings reveal that despite wide disparities in care that exist between and within countries, and the difficulties and challenges in implementing POS, significant progress has been made. We conclude that universal POS is not easy to implement in Latin America but, when executed, has not only been of significant value for babies with CHD, but also for many with other hypoxemic conditions. The successful and universal implementation of POS in the future is essential for reducing the mortality associated with CHD and other hypoxemic conditions and will ultimately lead to the survival of many more Latin American babies. POS saves newborns’ lives in Latin America. Full article
(This article belongs to the Special Issue Screening for Critical Congenital Heart Disease in Developing Countries)
6 pages, 507 KiB  
Review
Universal Screening for CCHD in Saudi Arabia: The Road to a ‘State of the Art’ Program
by Fahad AlAql, Huda Khaleel and Vetha Peter
Int. J. Neonatal Screen. 2020, 6(1), 13; https://doi.org/10.3390/ijns6010013 - 24 Feb 2020
Cited by 2 | Viewed by 3608
Abstract
Critical congenital heart disease (CCHD) has been defined as structural heart defects that are usually associated with hypoxia in the newborn period and have potential for significant morbidity and mortality early in life. CCHD has been estimated to be present in ∼3 in [...] Read more.
Critical congenital heart disease (CCHD) has been defined as structural heart defects that are usually associated with hypoxia in the newborn period and have potential for significant morbidity and mortality early in life. CCHD has been estimated to be present in ∼3 in 1000 live births, including Saudi Arabia. Pulse Oximetry Screening (POS) is a highly specific and moderately sensitive test for detecting CCHD with very low false-positive rates. The Kingdom of Saudi Arabia is among high-income countries with a population of more than 33 million and more than 600,000 annual live births. In 2015, the Universal Screening Program for CCHD using Pulse Oximetry was approved in Saudi Arabia. It is expected that any new national program will undergo a learning curve and face many challenges. We believe that developing countries may face different challenges during implementation of such national projects, but the success achieved by Saudi Arabia in implementing the program was mainly due to good preparation before launching the project and advancements in the use of the technology involved in this project. Since starting the universal CCHD screening in 2016, more than 900,000 babies have been screened in Saudi Arabia and many lives have been saved using this safe, non-invasive, inexpensive, and reasonably sensitive test. Full article
(This article belongs to the Special Issue Screening for Critical Congenital Heart Disease in Developing Countries)
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Other

5 pages, 802 KiB  
Commentary
Considerations for Newborn Screening for Critical Congenital Heart Disease in Low- and Middle-Income Countries
by Bistra Zheleva, Sreehari M. Nair, Adriana Dobrzycka and Annamarie Saarinen
Int. J. Neonatal Screen. 2020, 6(2), 49; https://doi.org/10.3390/ijns6020049 - 14 Jun 2020
Cited by 8 | Viewed by 3856
Abstract
We propose several considerations for implementation of critical congenital heart disease (CCHD) screening for low- and middle-income countries to assess health system readiness for countries that may not have all the downstream capacity needed for treatment of CCHD. The recommendations include: (1) assessment [...] Read more.
We propose several considerations for implementation of critical congenital heart disease (CCHD) screening for low- and middle-income countries to assess health system readiness for countries that may not have all the downstream capacity needed for treatment of CCHD. The recommendations include: (1) assessment of secondary and tertiary level CHD health services, (2) assessment of birth delivery center processes and staff training needs, (3) data collection on implementation and quality surgical outcomes, (4) budgetary consideration, and (5) consideration of the CCHD screening service as part of the overall patient care continuum. Full article
(This article belongs to the Special Issue Screening for Critical Congenital Heart Disease in Developing Countries)
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