LONG-TERM CLINICAL FOLLOW-UP OF CHILDREN BORN WITH ESOPHAGEAL ATRESIA IN SUB-SAHARAN AFRICA.

Corné de Vos [1,2], Daniel Sidler [3], Lizelle van Wyk [2], Pierre Goussard [2]

[1] Division of Pediatric Surgery, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa

[2] Department of Pediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Cape Town,

South Africa

[3] Division of Medical Ethics and Law, Stellenbosch University, Cape Town, South Africa

Abstract

Introduction: Esophageal atresia, previously perceived as predominantly a neonatal diagnosis associated with peri-operative morbidity, has evolved into a chronic condition distinguished by persistent issues throughout an individual's lifetime. This study aimed to identify specific domains that need to be integrated into a comprehensive long-term clinical follow-up for children born with EA in Sub-Saharan Africa.

Method: A prospective ambi-directional cohort study was undertaken that included all patients born with EA who received follow-up care in our unit from 2020 to 2024. The patient’s age at the time of visit and the nature of the visit were documented. The collected clinical information was categorized into aspects related to feeding and nutritional status, gastrointestinal (GI) complaints, respiratory complaints, and findings

derived from clinical examination.

Results: Eighty-seven study forms were completed during the study period. The median age at the time of follow-up was 32 months. 33%-49% cases documented feeding difficulties. Most patients aged 0-11 months had a weight-for-age below -2 or -3 SD, with 60% of older children exhibiting BMImeasurements below these parameters. The most common GI symptoms experienced included gastroesophageal reflux (72%), dysphagia (43%), and food bolus obstruction (29%). 76% had recurrent respiratory tract infections, and 29% presented with a persistent cough. No skeletal abnormalities were observed.

Conclusion: Our data highlights the significant impact of EA on the nutritional status, feeding patterns, GI, and respiratory systems of affected children in a center in Sub-Saharan Africa. Our results underscore the necessity of their inclusion in the long-term clinical follow-up of EA patients in resource-restricted environments.