Browsing by Author "Scheel, Amy"
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Item Comparison of approaches to determine echocardiographic outcomes for children with latent rheumatic heart disease(Open Heart, 2022) Rwebembera, Joselyn; Beaton, Andrea; Okello, Emmy; Nakitto, Miriam; Pulle, Jafesi; Scheel, Amy; Grobler, Anneke; Steer, Andrew Craig; Sable, CraigScreening programmes using echocardiography offer opportunity for intervention through identification and treatment of early (latent) rheumatic heart disease (RHD). We aimed to compare two methods for classifying progression or regression of latent RHD: serial review method and blinded, side-by-side review.Item Quality of Life in Ugandan Children and Young Adults After Surgery for Congenital Heart Disease: Mixed Methods Approach(Public Library of Science, 2024-04) Searchinger, Chloe; Nalubwama, Hadija; Pulle, Jafesi; Mehta, Rittal; Tumwbaze, Hilda; Kyarimpa, Rachel; Mwima, Rachel; Atukunda, Emily; Bua, Bobson; Sarnacki, Rachel; Sherman, Meredith G; Oketcho, Michael; Zimmerman, Meghan; Nakitto, Miriam; Longenecker, Chris T; Webel, Allison; Scheel, Amy; Lwabi, Peter S; Sable, Craig AHealth-related quality of life (HRQOL) is a critical issue for patients undergoing surgery for congenital heart disease (CHD) but has never been assessed in a low-income country. We conducted a cross-sectional mixed methods study with age-matched healthy siblings serving as controls at the Uganda Heart Institute. One-hundred fifteen CHD pediatric and young adult patients and sibling control participants were recruited. Health-related quality of life was assessed using the Pediatric Quality of Life Inventory Version 4.0 in participants ages 5-17 and 36-Item Short Form Survey for young adults aged 18-25. A subset of 27 participants completed face-to-face interviews to supplement quantitative findings. Eighty-six pediatric (age 5-17) sibling and parent pairs completed Peds QOL surveys, and 29 young adult (age 18-25) sibling pairs completed SF-36 surveys. One third of patients had surgery in Uganda. Ventricular septal defects and tetralogy of Fallot were the most common diagnoses. Health-related quality of life scores in patients were lower across all domains compared to control participants in children. Reductions in physical and emotional domains of HRQOL were also statistically significant for young adults. Variables associated with lower HRQOL score on multivariate analysis in pediatric patients were younger age in the physical and emotional domains, greater number of surgeries in the physical domain and surgery outside Uganda in the school domain. The only predictor of lower HRQOL score in young adults was surgery outside Uganda in the social domain. Qualitative interviews identified a number of themes that correlated with survey results including abandonment by family, isolation from peers and community, financial hardship and social stigmatization. Health-related quality of life was lower in Ugandan patients after CHD surgery than siblings. Younger patients and those who had surgery outside of Uganda had lower HRQOL. These data have important implications for patients undergoing CHD surgery in LMIC and have potential to inform interventions.