Browsing by Author "Schoonraad, Leilah"
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- ItemDescriptive review of the health supervision received by children with Down syndrome at Worcester Provincial Hospital from 2010 to 2015(Stellenbosch : Stellenbosch University, 2018-12) Schoonraad, Leilah; Slogrove, Amy; Engelbrecht, Arnold; Urban, Mike; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.ENGLISH ABSTRACT: Background: In 2011, the American Academy of Paediatrics (AAP) published revised guidelines for health supervision of children with Down syndrome (DS). In the absence of South African guidelines, we described the health supervision received by children with DS at a regional (level 2) Western Cape Hospital and compared it to the AAP guidelines. Methods: This was a 5 year retrospective description of implementation of the 2011 AAP recommendations at the DS clinic at Worcester Provincial Hospital (WPH), specifically related to cardiac, thyroid, hearing and haematological disorders. Data was extracted from patient medical folders and the National Health Laboratory Database. The proportion receiving screening components was compared between the children using WPH as their primary care facility and children referred from peripheral hospitals. Results: Sixty-two children received care at WPH DS clinic during the study period. Thirty-six (58%) children lived in Worcester while 26 (42%) were referred from peripheral hospitals. The median age at first clinic visit was 0.5 years (interquartile range (IQR) 0.2-1.2), there was a total of 177 person-years of follow up with a median duration of follow up of 1.8 years (IQR 0.3-4.8) and 2 deaths occurred in the study period. Forty nine children (79%) had a screening echocardiogram performed, the median age at first echocardiogram was 0.8 years (IQR 0.2-1.4). Five (13.9%) children from WPH compared to no children from the peripheral hospitals received the echocardiogram within the first month of life (p =0.056). Those requiring cardiac surgery were operated on at a median age of 2years (IQR 0.9-2.3). Compared to the AAP recommendations, within the first month of life 17 (27.4%) children had a thyroid screen, 20 (32.3%) children had a full blood count and 7 (11.3%) children had a hearing assessment. Conclusion: AAP recommendations 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 might improve the care of children with DS.