PMID- 31943102
OWN - NLM
STAT- MEDLINE
DCOM- 20201201
LR  - 20201201
IS  - 1465-3664 (Electronic)
IS  - 0142-6338 (Linking)
VI  - 66
IP  - 4
DP  - 2020 Aug 1
TI  - A 5-Year Retrospective Review of the Health Supervision Received by Children with 
      Down Syndrome at a South African Regional Hospital.
PG  - 441-447
LID - 10.1093/tropej/fmz087 [doi]
AB  - INTRODUCTION: In 2011, the American Academy of Paediatrics (AAP) published 
      revised health supervision guidelines for children with Down syndrome (DS). In 
      the absence of South African guidelines, we described the health supervision 
      received by children with DS at a rural regional hospital in the Western Cape, 
      South Africa compared with the AAP guidelines. METHODS: This was a 5-year 
      retrospective description of the implementation of the 2011 AAP guidelines at the 
      DS clinic at Worcester Provincial Hospital (WPH), specifically related to 
      screening for and management of cardiac, thyroid, hearing and haematological 
      disorders. RESULTS: Sixty-two children received care at WPH DS clinic during the 
      study period. Thirty-six (58%) children lived in Worcester while 26 (42%) 
      children were referred from peripheral hospitals. The median age at first clinic 
      visit was 0.5 years [inter-quartile range (IQR) 0.2-1.2], a total of 177 
      person-years of follow-up with a median duration of 1.8 years (IQR 0.3-4.8). Two 
      deaths occurred during the study period. Forty-nine (79%) children had a 
      screening echocardiogram performed, the median age at first echocardiogram was 
      0.8 years (IQR 0.2-1.4). Five (14%) children from WPH compared with no children 
      from the peripheral hospitals received the echocardiogram within the first month 
      of life in keeping with AAP guidance (p = 0.06). Those requiring cardiac surgery 
      were operated on at a median age of 2 years (IQR 0.9-2.3). Compared with the AAP 
      guidelines, within the first month of life 17 (27%) children had a thyroid 
      screen, 20 (32%) children had a full blood count and 7 (11%) children had a 
      hearing assessment. CONCLUSION: AAP guidelines for health supervision in DS are 
      challenging to achieve within our local health system. The development and 
      advocacy for a South African DS health supervision guideline that can be applied 
      not only in specialist clinics might improve the care of children with DS.
CI  - (c) The Author(s) [2020]. Published by Oxford University Press. All rights 
      reserved. For permissions, please email: journals.permissions@oup.com.
FAU - Schoonraad, Leilah
AU  - Schoonraad L
AD  - Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 
      7505, South Africa.
FAU - Slogrove, Amy
AU  - Slogrove A
AD  - Department of Paediatrics and Child Health, Ukwanda Centre for Rural Health, 
      Stellenbosch University, Cape Town 6849, South Africa.
FAU - Engelbrecht, Arnold
AU  - Engelbrecht A
AD  - Department of Paediatrics and Child Health, Worcester Provincial Hospital, 
      Western Cape 6850, South Africa.
FAU - Urban, Michael F
AU  - Urban MF
AD  - Department of Molecular Biology and Human Genetics, Tygerberg Hospital, 
      Stellenbosch University, Cape Town 7505, South Africa.
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Trop Pediatr
JT  - Journal of tropical pediatrics
JID - 8010948
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Down Syndrome/diagnosis/ethnology/*therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Genetic Counseling
MH  - *Guideline Adherence
MH  - Health Knowledge, Attitudes, Practice
MH  - Hospitals
MH  - Humans
MH  - Lost to Follow-Up
MH  - Male
MH  - Patient Education as Topic
MH  - Pediatrics/methods/*standards
MH  - Rural Population
MH  - South Africa
OTO - NOTNLM
OT  - Down syndrome
OT  - South Africa
OT  - trisomy 21
EDAT- 2020/01/17 06:00
MHDA- 2020/12/02 06:00
CRDT- 2020/01/17 06:00
PHST- 2020/01/17 06:00 [pubmed]
PHST- 2020/12/02 06:00 [medline]
PHST- 2020/01/17 06:00 [entrez]
AID - 5704801 [pii]
AID - 10.1093/tropej/fmz087 [doi]
PST - ppublish
SO  - J Trop Pediatr. 2020 Aug 1;66(4):441-447. doi: 10.1093/tropej/fmz087.