Key result
Delayed cardiac surgery exceeds 12 months in ~69% of patients, driven by financial constraints.
Why the study?
In low- and middle-income countries, limited access to definitive cardiac surgery for congenital heart disease leads to delays that may cause clinical deterioration, recurrent hospitalisation, and substantial family burden. This study assessed the challenges and consequences associated with delayed cardiac surgery among children at a Nigerian teaching hospital.
Cross-Sectional (n=75)
No
This study highlights that Nigerian children with congenital heart disease face prolonged surgical delays (median 23 months) primarily due to financial constraints and lack of local surgical capacity, leading to high rates of clinical deterioration, hospitalization, and severe family burden.
Answers are grounded in this paper and cite their sources.
Financially driven delays in pediatric congenital heart surgery associate with symptom worsening and hospitalizations; leaves open targeted access interventions in low-resource settings.
Background: Congenital heart disease (CHD) is an important cause of childhood morbidity and mortality, particularly in low- and middle-income countries where access to definitive cardiac surgery remains limited. Delayed surgery may result in clinical deterioration, recurrent hospitalisation and substantial socioeconomic and emotional burden on affected families. This study assessed the challenges associated with delayed cardiac surgery among children with CHD attending the University of Benin Teaching Hospital (UBTH), Benin City. Methods: This was a cross-sectional descriptive study involving 75 children aged 0–18 years with echocardiographically confirmed CHD whose caregivers had been counselled for cardiac surgery. Participants were recruited consecutively from the paediatric cardiology clinic. Data on sociodemographic characteristics, clinical diagnosis, duration and perceived causes of surgical delay, clinical consequences, family impact and coping strategies were obtained using a structured proforma and medical record review. Data were analysed using SPSS version 27 and presented as frequencies, percentages, medians and interquartile ranges. Results: The median age of the children was 36 months (IQR: 24–72), while the median age at diagnosis was 11 months (IQR: 1.5–36). Ventricular septal defect (34.7%) and tetralogy of Fallot (18.7%) were the commonest diagnoses. The median duration of surgical delay was 23 months (IQR: 12–36), with 69.3% experiencing delays exceeding 12 months. Financial constraints (96.0%), unavailability of local cardiac surgery centres (64.0%) and lack of health insurance (61.3%) were the major reported barriers. Worsening symptoms occurred in 62.7%, while 69.3% required hospitalisation during the waiting period. Family consequences included increased financial strain (84.0%), disruption of caregiver income (57.3%) and emotional stress (98.7%). Conclusion: Delayed cardiac surgery is common among children with CHD at UBTH and is associated with substantial clinical, financial and emotional consequences. Strengthening financial protection, expanding local cardiac surgical capacity and improving referral and early intervention pathways are essential to reduce delays.
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Ezeuko et al. (2026) conducted a cross-sectional in Congenital heart disease (n=75). Delayed cardiac surgery (>3 months after recommendation) was evaluated on Surgical delay exceeding 12 months. Delayed cardiac surgery had a median duration of 23 months (69.3% >12 months), driven by financial constraints (96.0%) and causing worsening symptoms in 62.7% and hospitalization in 69.3%.
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