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Congenital heart disease in low-and-middle-income countries: Focus on sub-Saharan Africa.
American Journal of Medical Genetics Seminars in Medical Genetics, Part C ( IF 3.1 ) Pub Date : 2020-02-06 , DOI: 10.1002/ajmg.c.31769
Meghan Zimmerman 1 , Craig Sable 2
Affiliation  

The etiology of congenital heart disease (CHD) is multifactorial. The birth prevalence of CHD is shaped by a wide variety of maternal, fetal, and neonatal risk factors, along with the rates of prenatal diagnosis and terminations of pregnancy, all of which have geographic variability Epidemiology data availability from low-and-middle-income countries (LMIC) on CHD prevalence, morbidity, and mortality are far more limited than from high income countries. Data on specific genetic, environmental, and prenatal risk associated with CHD are almost nonexistent. In this article, we will focus on defining what data are available, genetic risk factors, birth and overall prevalence, morbidity, and the impact of limited access to interventions, both surgery and cardiac catheterizations. We will highlight CHD in sub-Saharan Africa to detail epidemiology studies in the poorest regions of the world. Existing literature as well as estimates from the Global Burden of Disease Study (http://ghdx.healthdata.org) form the basis for this review. The intersection of poverty, high fertility rates, and limited access to care results in a unique profile of CHD in LMIC. CHD is not a preventable disease (by most standards), so early detection and access are our key interventions to improve the dire outcomes for children in low-resources settings of the world.

中文翻译:

中低收入国家的先天性心脏病:关注撒哈拉以南非洲。

先天性心脏病(CHD)的病因是多因素的。冠心病的出生流行受多种母亲,胎儿和新生儿危险因素以及产前诊断和终止妊娠的影响,所有这些因素都具有地域可变性中低收入人群的流行病学数据可用性冠心病患病率,发病率和死亡率的国家(LMIC)远比高收入国家受到的限制更大。与冠心病相关的特定遗传,环境和产前风险的数据几乎不存在。在本文中,我们将重点定义可用的数据,遗传风险因素,出生和总体患病率,发病率,以及手术和心脏导管插入术等有限的干预措施的影响。我们将重点介绍撒哈拉以南非洲的冠心病,以详细介绍世界上最贫困地区的流行病学研究。现有文献以及《全球疾病负担研究》(http://ghdx.healthdata.org)的估计构成了本文的基础。贫困,高生育率和有限的就医机会导致了中低收入国家冠心病的独特特征。冠心病不是一种可预防的疾病(按照大多数标准),因此尽早发现和获取冠心病是我们改善世界上资源匮乏地区儿童可怕后果的关键干预措施。有限的护理机会导致LMIC中CHD的独特性。冠心病不是一种可预防的疾病(按照大多数标准),因此尽早发现和获取冠心病是我们改善世界上资源匮乏地区儿童可怕后果的关键干预措施。有限的护理机会导致LMIC中CHD的独特性。冠心病不是一种可预防的疾病(按照大多数标准),因此尽早发现和获取冠心病是我们改善世界上资源匮乏地区儿童可怕后果的关键干预措施。
更新日期:2020-04-21
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