Don canvasses expansion of NHIA to cater for heart problems in children

A Professor of Paediatrics at the University of Lagos, Ekanem Nsikak Ekure, has advocated the expansion of the National Health Insurance Act (NHIA) to include cardiac care for children.

Speaking at the 11th Inaugural Lecture of the 2021/2022 Academic Session recently, she also called for the establishment of cardiac intervention centres that provide care for children.

With the theme, “A Heartfelt Journey of Discoveries: ‘Little Hearts,’ Genes and Faces”, Prof. Ekure disclosed that her journey started with a study of cardiovascular disorders in childhood autopsies in Lagos University Teaching Hospital (LUTH) over a 10-year period.

The study found that 4.7 per cent of the over 2,000 children in a 10-year period had heart disease, while seven out of every 10 children with heart disease, Congenital Heart Disease (CHD), were born with it.

Speaking further, she added that based on a study involving over 4,000 school children, she observed that Rheumatic Heart Disease (RHD) was no longer a common acquired heart disease in children in Lagos, as only 11 children (0.27 per cent) had RHD.

She disclosed that the next phase of her heartfelt discoveries led to the unravelling of the causes of CHD in Nigerian children. The work showed that maternal infection, where rubella was a frequent cause of CHD, a condition that could be prevented with rubella-containing vaccine.

She identified another risk factor as heredity, with a third of over 700 children with CHD in LUTH had extracardiac anomalies indicative of a genetic syndrome; the most common being Down syndrome.

For the prevention of cardiac diseases in children, she advocated preconception care, urging people to avoid giving birth at an advanced age.

She further recommended compulsory pulse oximetry in all new-born babies for early detection of critical congenital heart disease; and widespread introduction of electronic medical records into clinical practice to facilitate utilisation of facial digital analysis technology by clinicians.

Other recommendations include, the incorporation of digital phenotyping of syndromic patients into routine clinical evaluation of patients in hospitals; development of national policies and programmes to provide better screening and detection, coordinate clinical management, facilitate training of professionals, and stimulate research into cardiac and genetic disorders in children.