Taking the pulse of Timor-Leste's cardiac needs: a ten-year descriptive time-trend analysis: Cardiac care in Timor-Leste

BACKGROUND: Timor-Leste is one of the poorest countries in the world. The East Timor Hearts Fund (ETHF) is a charitable organization involving Australian cardiologists providing outreach screening and access to cardiac interventions. METHODS: The ETHF database was sectioned into two-year intervals (2009/10, 2011/12, 2013/14, 2015/16, 2017/18). Demographics and clinical outcomes of patients were compared, with subgroup analysis of adult (>18 years old), paediatric and interventional patients. RESULTS: Over ten years 2,050 patient encounters have occurred; 1,119 (54.6%) encounters occurred in 2017/18. 73.6% of patients were assessed in the capital Dili. Rheumatic and congenital cardiac disease remain very common (39.1% of adult new patients and 74.2% of paediatric new patients), with 1.4% of new patients exhibiting both pathologies. The number of new patients with rheumatic or congenital heart disease tripled in 2017/18 compared to 2009/10 (99 vs 34 patients, p<0.0001). Paediatric case volume increased over ten-fold over ten years (288 new patients in 2017/18 vs 24 in 2009/10, p<0.0001), with corresponding increase in proportion of paediatric interventions (59.4% in 2017/18 vs 25.0% in 2009/10, p=0.027). For patients undergoing intervention (n=87), post-procedural complications and mortality are extremely low (3.4% and 1.1% respectively), with all eligible patients attending at least one post-procedure appointment. CONCLUSION: Demand for cardiac services in Timor-Leste is rising exponentially, with inequitable geographic coverage. Rheumatic and congenital cardiac disease remain priorities for assessment, and paediatric case volume is increasing. Patients undergoing intervention experience good medical outcomes. This article is protected by copyright. All rights reserved.