Profile of major congenital anomalies seen at University Teaching Hospital, Lusaka: A petition for congenital anomalies surveillance

Abstract

To describe the profile of congenital anomalies at University Teaching Hospital (UTH), Lusaka with special reference to implications for training and integrating congenital anomalies prevention strategies in primary health care. The profile of congenital anomalies was determined by reviewing research records that had been collected over a period of 20 years (January 1985 January 2005). The total incidence of major congenital anomalies was 1.6% (n = 5,478) of the patients who attended the neonatal and paediatric surgical wards during the period under study. The categories of effects with the highest prevalence were, digestive system anomalies (38.9%), nervous system anomalies (31.5%), cleft lip and palate (12.3%) and rirogenital anomalies (9.7%). Of note was the relative low contribution of congenital heart disease (1.7%). The commonest digestive system anomalies were severe aganglionosis (n = 701), ano-recto atresia (n = 501), jejenual and duodenal atresias (n = 270) and exomphalos (n = 101); The central nervous system anomalies included spina bifida (n = 1,500), encephalocoele (n = 121); those for orofacial clefts were cleft lip and palate (n = 670); and for the urogenital system congenital hydronephrosis (n =210),ectopicbladder(n=99)andambiguousgenitalia (n = 75). Other congenital anomalies recorded included osteogenesis imperfecta, achondroplasia, congenital dislocation of the hip, patent ductus arteriosus, ventricular septal defect, tricuspid atresia, Down's syndromeandPierreRobinsyndrometolistafew. Major congenital anomalies are prevalent in Zambia, and the incidence may be increasing. The considerable challenge posed by major congenital malformations in Zambia arouses the need for the establishment of hospital Congenital Abnormalities Registry and Surveillance System (CARSS) and its inclusion on the Health Monitoring Information System(HMIS), and ultimately the development _of prevention programmes through the integration of preventive measures into primary health care and maternal and child health services.