Prevalence of rheumatic heart disease among school‐children in Aden, Yemen

Ba-Saddik, Iman Ali; Munibari, A-Nasser; Al‐Naqeeb, M S; Parry, Christopher M.; Hart, C. A.; Cuevas, Luís E.; Coulter, J. B. S.

doi:10.1179/1465328110y.0000000007

Cited by 25 publications

(20 citation statements)

References 44 publications

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“…Only the student who had a previous history of FRA exhibited moderate MR and AoR. It was thus possible to conclude that the Doppler echocardiographic study was more effective than physical examination in the identification of valvular dysfunction, as had already been demonstrated in several studies of valvular disease screening in students 9,10,14,23-27 .…”

Section: Discussionmentioning

confidence: 63%

“…This is mainly because there is a risk of abusive use of Doppler echocardiography testing for this purpose and because its use by less experienced examiners can lead to excessive diagnoses and unnecessary exposure to secondary prophylaxis 7,18 . Many authors have presented studies using portable Doppler echocardiography to perform screening tests, mainly in students, to screen subclinical cases of rheumatic valvular involvement without clinical expression 7,9,10,20,23-27 .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the frequency of valvular changes consistent with rheumatic disease was 5 times higher on Doppler echocardiography evaluation (18.7/1000, 95% CI 6.9/1000-41.0/1000) than on clinical evaluation (3.7/1000); moreover, it was higher with for MR (18.7/1000, 95% CI 6.9/1000-41.0/1000) than for AoR (7.5/1000, 95% CI 1.2/1000-24.5/1000). In previous screening studies with students this distinction between the frequency of involvement of mitral and aortic valves had not been made 2,10,18,23-27 .…”

Section: Discussionmentioning

confidence: 99%

“…However, the sample size was calculated considering the prevalence of RF obtained in a clinical study also conducted in a school in Belo Horizonte 36 and the higher detection of valvular disease using Doppler echocardiography evaluation, according to the results of several screening studies conducted in schools 1,9,10,23-27,37-40 . The study sample was selected centrally in a single school.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Rheumatic Heart Disease in a Public School of Belo Horizonte

Miranda¹,

Camargos²,

Torres³

et al. 2014

Arquivos Brasileiros De Cardiologia

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Background Previous studies indicate that compared with physical examination, Doppler echocardiography identifies a larger number of cases of rheumatic heart disease in apparently healthy individuals. Objectives To determine the prevalence of rheumatic heart disease among students in a public school of Belo Horizonte by clinical evaluation and Doppler echocardiography. Methods This was a cross-sectional study conducted with 267 randomly selected school students aged between 6 and 16 years. students underwent anamnesis and physical examination with the purpose of establishing criteria for the diagnosis of rheumatic fever. They were all subjected to Doppler echocardiography using a portable machine. Those who exhibited nonphysiological mitral regurgitation (MR) and/or aortic regurgitation (AR) were referred to the Doppler echocardiography laboratory of the Hospital das Clínicas of the Universidade Federal of Minas Gerais (HC-UFMG) to undergo a second Doppler echocardiography examination. According to the findings, the cases of rheumatic heart disease were classified as definitive, probable, or possible. Results Of the 267 students, 1 (0.37%) had a clinical history compatible with the diagnosis of acute rheumatic fever (ARF) and portable Doppler echocardiography indicated nonphysiological MR and/or AR in 25 (9.4%). Of these, 16 (6%) underwent Doppler echocardiography at HC-UFMG. The results showed definitive rheumatic heart disease in 1 student, probable rheumatic heart disease in 3 students, and possible rheumatic heart disease in 1 student. Conclusion In the population under study, the prevalence of cases compatible with rheumatic involvement was 5 times higher on Doppler echocardiography (18.7/1000; 95% CI 6.9/1000-41.0/1000) than on clinical evaluation (3.7/1000-95% CI).

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of Rheumatic Heart Disease in a Public School of Belo Horizonte

Miranda¹,

Camargos²,

Torres³

et al. 2014

Arquivos Brasileiros De Cardiologia

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“…The epidemiology of RHD varies by region [17], with a particularly high prevalence in Africa [32, 38, 39] and the Pacific region [40–43] but a high burden also in Latin America [44], the Middle East [45, 46] and Asia [17, 47]. The age-distribution of prevalent RHD cases globally reflect two distinct epidemics.…”

Section: Current Epidemiology Of Gas Arf and Rhd Around The Worldmentioning

confidence: 99%

Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease: Epidemiology and Clinical Considerations

Zühlke

Beaton

Engel

et al. 2017

Curr Treat Options Cardio Med

127

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Opinion statementEarly recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-to-high risk populations. Initiation of secondary prophylaxis and the establishment of early medium to long-term care plans is a key aspect of the management of ARF. It is a requirement to identify high-risk individuals with RHD such as those with heart failure, pregnant women, and those with severe disease and multiple valve involvement. As penicillin is the mainstay of primary and secondary prevention, further research into penicillin supply chains, alternate preparations and modes of delivery is required.

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Echocardiographic Screening for Subclinical Rheumatic Heart Disease Remains a Research Tool Pending Studies of Impact on Prognosis

Zühlke

Mayosi

2013

Curr Cardiol Rep

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The application of portable echocardiography to the screening of asymptomatic children and young adults for rheumatic heart disease (RHD) in developing countries indicates that the disease may affect 62 million to 78 million individuals worldwide, which could potentially result in 1.4 million deaths per year from RHD and its complications. The World Heart Federation has developed a guideline for the echocardiographic diagnosis of RHD in asymptomatic individuals without a history of acute rheumatic fever (ARF) in order to ensure the reliability, comparability, and reproducibility of findings of the echocardiographic screening studies. Early studies suggest that a third of individuals with asymptomatic subclinical RHD revert to normal echocardiographic findings on repeat testing after 6-12 months, suggesting that repeat echocardiography may be necessary to confirm the findings prior to consideration of interventions such as antibiotic prophylaxis. It is not known, however, whether echocardiographic screening for asymptomatic subclinical RHD or the introduction of antibiotic prophylaxis for affected individuals improves the prognosis of RHD. Furthermore, the cost-effectiveness of this screening method has not been established in the vast majority of affected countries. Therefore, echocardiographic screening for asymptomatic subclinical RHD remains a research tool until studies of impact on prognosis and cost-effectiveness are conducted.

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Prevalence of rheumatic heart disease among school‐children in Aden, Yemen

Abstract: The high prevalence of RHD is a major public health problem in Yemen. Urgent screening surveys and an RHD prophylactic programme of appropriate management of group A β-haemolytic streptococcal pharyngotonsilitis are required.

Cited by 25 publications

References 44 publications

Prevalence of Rheumatic Heart Disease in a Public School of Belo Horizonte

Prevalence of Rheumatic Heart Disease in a Public School of Belo Horizonte

Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease: Epidemiology and Clinical Considerations

Echocardiographic Screening for Subclinical Rheumatic Heart Disease Remains a Research Tool Pending Studies of Impact on Prognosis

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