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The Namibian Children’s Heart Project: a South–South partnership to provide cardiac care
- Fenny F. Shidhika, Christopher T. Hugo-Hamman, John B. Lawrenson, Henning J. Du Toit, Susan M. Vosloo, Andre Brooks, Harold S. Pribut, Susan R. Perkins, Liesl J. Zühlke
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- Journal:
- Cardiology in the Young / Volume 29 / Issue 2 / February 2019
- Published online by Cambridge University Press:
- 20 February 2019, pp. 206-213
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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.
ObjectivesTo describe the diagnoses, clinical characteristics, interventions, post-operative morbidity and mortality, and follow-up of patients referred for care.
MethodsDemographics, diagnoses, interventions, intra- and post-operative morbidity and mortality, as well as longitudinal follow-up data of all patients referred to South Africa, were recorded and analysed.
ResultsThe total cohort constituted 193 patients of which 179 (93%) had CHD and 7% acquired heart disease. The majority of patients (78.8%) travelled more than 400 km to Windhoek before transfer. There were 28 percutaneous interventions. Palliative and definitive surgery was performed in 27 and 129 patients, respectively. Out of 156 patients, 80 (51.3%) had post-operative complications, of which 15 (9.6%) were a direct complication of surgery. Surgical mortality was 8/156 (5.1%, 95% confidence interval 2.2–9.8), with a 30-day mortality of 3.2%. Prolonged ICU stay was associated with a 5% increased risk of death with hazard ratio 1.05, 95% confidence interval 1.02–1.08, p=0.001. Follow-up was complete in 151 (78%) patients for more than 7 years.
ConclusionsDespite the challenges associated with a cardiac programme for referring patients seeking intervention in 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.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. 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- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Contributors
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- By James M. Bjork, Hilary P. Blumberg, Nathalie Boddaert, Susan Bookheimer, Silvia A. Bunge, Beata Buzas, B. J. Casey, Nadia Chabane, Eveline A. Crone, Mirella Dapretto, John A. Detre, Vaibhav A. Diwadkar, Jeffery N. Epstein, Monique Ernst, Guido K. W. Frank, David C. Glahn, David Goldman, Daniel A. Gorman, Ian H. Gotlib, Michael G. Hardin, Clinton D. Hermes, Rebecca M. Jones, Jutta Joormann, Jessica H. Kalmar, Walter H. Kaye, Matcheri S. Keshavan, Dae-Shik Kim, Liat Levita, Lisa H. Lu, Rachel Marsh, Kristin McNealy, Kevin A. Pelphrey, Susan B. Perlman, Bradley S. Peterson, Daniel S. Pine, Steven R. Pliszka, Konasale Prasad, Hengyi Rao, Allan L. Reiss, Perry Renshaw, Susan M. Rivera, Jason Royal, Judith M. Rumsey, Maulik P. Shah, Marisa M. Silveri, Elizabeth R. Sowell, Jeffrey A. Stanley, Henning U. Voss, Jiong-Jiong Wang, Ke Xu, Deborah Yurgelun-Todd, Monica Zilbovicius
- Edited by Judith M. Rumsey, National Institute of Mental Health, Bethesda, Maryland, Monique Ernst, National Institute of Mental Health, Bethesda, Maryland
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- Neuroimaging in Developmental Clinical Neuroscience
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- 04 August 2010
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- 19 February 2009, pp vii-xii
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Development of the gastrointestinal tract
- Susan J. Henning
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- Proceedings of the Nutrition Society / Volume 45 / Issue 1 / February 1986
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- 28 February 2007, pp. 39-44
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Diurnal variations in the concentrations of volatile fatty acids in the alimentary tracts of wild rabbits
- Susan J. Henning, F. J. R. Hird
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- British Journal of Nutrition / Volume 27 / Issue 1 / January 1972
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- 24 July 2007, pp. 57-64
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- January 1972
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1. Wild rabbits were caught during both phases of the excretory cycle and their gut contents were analysed for volatile fatty acids (VFA).
2. All rabbits were found to have high concentrations of VFA in the caecum and in the proximal colon. Acetic was the most abundant acid followed by n-butyric, then propionic.
3. VFA concentrations in the caecum and in the proximal colon of rabbits caught during the day and during the night were similar. Hard pellets from the distal colon and rectum of rabbits caught during the night had considerably less VFA than did the soft pellets from rabbits caught during the day.
4. Owing to the ingestion of soft faeces, the VFA content of stomach material was greater in rabbits caught during the day than in those caught at night.
5. The results are discussed in terms of the mechanism of the diurnal excretion pattern and the role of coprophagy in the rabbit.
Concentrations and metabolism of volatile fatty acids in the fermentative organs of two species of kangaroo and the guinea-pig
- Susan J. Henning, F. J. R. Hird
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- Journal:
- British Journal of Nutrition / Volume 24 / Issue 1 / March 1970
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- 09 March 2007, pp. 145-155
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- March 1970
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1. Contents from the fermentative organs of the kangaroo and guinea-pig were found to have concentrations of total volatile fatty acids ranging from 50 to 140 mM.
2. In each instance acetic was the most abundant acid, followed by propionic, then n-butyric, Trace amounts of isobutyric, n-valeric and isovaleric acids were present.
3. When studiedin vitro, tissue from the wall of each fermentative organ was shown to metabolize butyrate to ketone bodies. Acetoacetate was the major ketone body. The presence of acetate and propionate did not affect ketogenesis from butyrate.
4. In the guinea-pig caecum most of the ketogenic activity resided in the mucosa.
5. The upper colon of the guinea-pig was as active as the caecum in metabolizing butyrate to ketone bodies.
6. For both the guinea-pig caecum and the kangaroo fermentative stomach, incubations with 14C-labelled butyrate showed that the proportion oxidized to CO2 was considerably less than that metabolized to ketone bodies.