title: Successful training of self-sufficient interventional paediatric cardiology team in a sub-Saharan setting: a multicentre collaborative model.
abstract: BACKGROUND
  Most children in the Third World do not have access to treatment for heart diseases, as the priorities of health care are different from the developed countries.
  
  
  METHODS
  Since 2009, teams supported by the Chain of Hope and Spanish medical volunteers have travelled twice a year to help develop paediatric cardiac services in the Cardiac Center in Ethiopia, undertaking four missions each year. As of December 2012, 296 procedures were performed on 287 patients. The procedures included 128 duct occlusions, 55 pulmonary valve dilations, 25 atrial septal defect closures, 14 mitral valve dilations, and others. The local staff were trained to perform a majority of these cases.
  
  
  RESULTS
  Procedural success was achieved in 264 (89.2%). There were three deaths, five device embolisations, and three complications in mitral valve dilation. During the visits, the local staff were trained including one cardiologist, six nurses, and two technicians. The local team performed percutaneous interventions on its own after a couple of years. The goal is also to enable the local team to perform interventions independently.
  
  
  CONCLUSIONS
  Training of an interventional cardiology team in a sub-Saharan setting is challenging but achievable. It may be difficult for a single centre to commit to sending frequent missions to a developing country to make a meaningful contribution to the training of local teams. In our case, coordination between the teams from the two countries helped to achieve our goals.
authors.affiliation: 1Department of Pediatrics and Child Health,Cardiology Division,School of Medicine,Addis Ababa University,Addis Ababa,Ethiopia.
authors.forename: Endale
authors.initials: E
authors.lastname: Tefera
authors.affiliation: 2Evelina London Children's Hospital,Guys and St Thomas' Foundation Trust,London,United Kingdom.
authors.forename: Shakeel A
authors.initials: SA
authors.lastname: Qureshi
authors.affiliation: 3Department of Pediatric Cardiology,Ramon y Cajal University Hospital,Madrid,Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Bermudez-Cañete
mesh_terms: D000293:Adolescent; D000328:Adult; D002309:Cardiology / Q000193:education*; D002648:Child; D002675:Child, Preschool; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008493:Medical Missions; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D010372:Pediatrics / Q000193:education*; D011183:Postoperative Complications / Q000401:mortality
keywords: Interventional catheterisation; paediatric cardiology service; sub-Saharan setting