Is India geared up for regular screening of CHDs in kids?
Chennai: Congenital Heart Defects (CHDs) are among the most common types of birth defects. One out of 100 babies is born with CHD worldwide and nearly 40,000 infants in the US are born with CHD each year. In India, approximately 300,000 children are born with CHD each year and approximately 25% die before their first birthday. The absence of early screening and sophisticated pediatric care is causing over 250 child deaths every day in India.
Conventional stethoscopes used for screening have resulted in 28 percent false positives and 51 percent false negatives when used by non-specialists and health workers. While the Ultrasound Echocardiogram is a more accurate alternative, high equipment cost and low availability of trained medical professionals have limited their usage.
There is no practice of any preventive check-up for the heart in India, unless symptoms show up. This is true for adults or children, people living in citiesor villages. Most pediatric clinics are not equipped for cardiac tests even in urban areas, while in rural areas, the availability of pediatric clinics and pediatricians isvery low, almost nil in many towns.
Technological advances were adopted effectively by many sectors like telecom, IT, banking etc. The continued adoption of new technologies in the telecom sector has succeeded in connecting even the remotest parts of India, and over 50% of Indians now have cellphone access. Though healthcare is a late adopter of technology, its use is growing rapidlyover thelast decades. The great advantages of technology vis-à-vis growth, cost reduction and saving time are seen in healthcare as well. Some NGOs like Sathya Sai Sanjeevani Hospital use smart medical devices to conduct the screening of children in schools.They demonstrated how smart devices can change the way healthcare functions, how they can improve reach and connect remote locations inIndia as rapidly as cellphone penetration.
HD Medical (https://hdmedicalgroup.com/about/) is a US-based company with their R&D Centre located in Chennai, India. They have developed the HD Steth, cleared by US FDA that addresses this problem, providing a cost-effective, easy-to-use solution for non-specialists and primary healthcare workers. HD Steth is a3-in-1 smart device with ECG, PCG and Stethoscope functions plus a mobile app. HD Steth utilizes AI-enabled technology and it helps the front-end paramedical staff to identify the murmur, in case a qualified pediatric cardiologist is not available in that location.Recordings of the Heart Sound, PCG and ECG can be shared with the specialist anywhere in the world through email or WhatsApp.Thespecialist can even view the child over video, see the ECG, PCG and hearthe heart sound in real time.
HD Steth was tested and validated through a clinical study involving 1,200 children, with 90 percent sensitivity and 99 percent specificity for detecting heart murmurs caused by CHD compared to Ultrasound Echocardiograms as a gold standard at the Sri Sathya Sai Sanjeevani Hospital at Raipur, Chhattisgarh State in Central India.
Based on this study, HD Steth was adopted in a large CHD screening program at their group hospitals and medical screening programs at multiple locations in India.The Sri Sathya Sai Sanjeevani hospitals in Maharashtra, Chhattisgarh and Haryana are India’s largest providers of totally free pediatric heart procedures, performing nearly 14,000 surgeries and catheter interventions since 2012. “The centers stand committed to the investment in child health initiatives for a healthier nation in the future by offering quality healthcare provided totally free of cost,” said C. Sreenivas, Chairman of Sai Sanjeevani hospitals. “The HD Steth device from HD Medical is very helpful for screening children with CHD at an early stage so that a timely surgical intervention can be possible to save their lives.”
“HD Steth is very easy to use by non-specialists with minimal training requirements, for cardiac auscultation and as a screening tool. We started a program to screen over 100,000 children in Chickaballapur District in Karnataka State during October 2020 and so far, have screened close to 20,000 children despite COVID-19”, said Dr. Satish Babu, a leading Endocrinologist trained at Cambridge University Hospital, King’s College Hospital and Cardiff University Hospital in the UK and currently practicing at Sri Sathya Sai Sarla Memorial Hospital, Muddenahalli near Bengaluru, Karnataka.
When it comes to healthcare, though the relevant technology and smart devices are available, it is imperative for each clinician to adopt this technology swiftly to deliver better healthcare to people living across India.
