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Background <p>Congenital heart disease (CHD) represents a major contributor to the global burden of childhood disease. However, its burden across diverse socioeconomic and healthcare contexts in Asia remains poorly understood. This study compared CHD prevalence and its associations with socioeconomic conditions and health service capacity among school-age children in Nepal and two Chinese provinces (Yunnan and Xinjiang).</p> Method <p>Cross-sectional studies were conducted in Nepal to two provinces in China (Yunnan Province and Xinjiang Uygur Autonomous Region) from June 2024 and May 2025. CHD screening consisted of cardiac auscultation followed by echocardiography for suspected or previously diagnosed cases. Children’s CHD prevalence, socio-economic levels and health service capacity in three regions were compared. Ridge regression was performed at the district/county level to examine the association between socioeconomic and health service capacity factors and the risk of CHD.</p> Results <p>A total of 429,204 school-age children were screened, identifying 1,771 children with CHD. Marked interregional differences in CHD prevalence were observed: Nepal exhibited the highest prevalence (5.99 per 1,000 children), followed by Xinjiang (4.51 per 1,000 children) and Yunnan (3.42 per 1,000 children). Substantial disparities in socioeconomic and healthcare indicators were also evident across regions. GDP per capita (USD) ranged from 1,378 in Nepal to 8,751 in Yunnan and 10,071 in Xinjiang, while hospital bed density (per 1,000 population) was 0.39 in Nepal compared to 7.70 and 7.60 in Yunnan and Xinjiang, respectively. Ridge regression analysis revealed that hospital bed density was significantly negatively correlated with CHD prevalence.</p> Conclusion <p>Substantial differences in CHD prevalence, socioeconomic conditions, and health service capacity were observed across the three regions. Children’s CHD prevalence was associated with health service capacity, suggesting that greater access to health service capacity may correspond with lower CHD prevalence at the population level.</p>

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Prevalence of congenital heart disease in school-aged children and its association with socioeconomic and health service capacity factors: a comparative study of Nepal and China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月21日

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  • Kai Bai,
  • Yu Xia,
  • Gajurel Sharad,
  • Teng Wang,
  • Liping He,
  • Yue Gao,
  • Krishna Garu,
  • Yuling Lu,
  • Shuyue Zhang,
  • Lin Duo,
  • Urmila Shakya,
  • Jiang Lu

摘要

Background

Congenital heart disease (CHD) represents a major contributor to the global burden of childhood disease. However, its burden across diverse socioeconomic and healthcare contexts in Asia remains poorly understood. This study compared CHD prevalence and its associations with socioeconomic conditions and health service capacity among school-age children in Nepal and two Chinese provinces (Yunnan and Xinjiang).

Method

Cross-sectional studies were conducted in Nepal to two provinces in China (Yunnan Province and Xinjiang Uygur Autonomous Region) from June 2024 and May 2025. CHD screening consisted of cardiac auscultation followed by echocardiography for suspected or previously diagnosed cases. Children’s CHD prevalence, socio-economic levels and health service capacity in three regions were compared. Ridge regression was performed at the district/county level to examine the association between socioeconomic and health service capacity factors and the risk of CHD.

Results

A total of 429,204 school-age children were screened, identifying 1,771 children with CHD. Marked interregional differences in CHD prevalence were observed: Nepal exhibited the highest prevalence (5.99 per 1,000 children), followed by Xinjiang (4.51 per 1,000 children) and Yunnan (3.42 per 1,000 children). Substantial disparities in socioeconomic and healthcare indicators were also evident across regions. GDP per capita (USD) ranged from 1,378 in Nepal to 8,751 in Yunnan and 10,071 in Xinjiang, while hospital bed density (per 1,000 population) was 0.39 in Nepal compared to 7.70 and 7.60 in Yunnan and Xinjiang, respectively. Ridge regression analysis revealed that hospital bed density was significantly negatively correlated with CHD prevalence.

Conclusion

Substantial differences in CHD prevalence, socioeconomic conditions, and health service capacity were observed across the three regions. Children’s CHD prevalence was associated with health service capacity, suggesting that greater access to health service capacity may correspond with lower CHD prevalence at the population level.