The Echocardiographic Prevalence of Rheumatic Heart Disease in North Kordofan and Initiation of a Control Program

Ali, Sulafa; Domi, S.; Elfaki, AbdelSalam Mohamed Hamad

doi:10.12816/0039456

Cited by 14 publications

(13 citation statements)

References 4 publications

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“…Another study showed the age groups from 11-30 years to be the most affected with RHD. 23 Similarly, our study confirmed that age groups above 25 years have higher incidence. This may be related to the lack of health services, timely diagnosis and treatment.…”

Section: Discussionsupporting

confidence: 83%

“…Khartoum, being the capital city of North Darfur, was estimated to have 0.03%, and that prevalence are dominated by the North Kordofan state (with 6.1% of RHD). [23][24][25] On the other hand, our study revealed that North Darfur has only 0.03% of RHD, which reduced to 0.019% in 2017 (the population density of North Darfur was obtained from the Central Statistical Organization report).…”

Section: Discussionmentioning

confidence: 58%

“…Our findings are in line with previous studies conducted in Sudan and some parts of Asia, such as India and Pakistan, which gave similar results but showed a lower female to male ratio. [21][22][23] This could be explained by women seeking medical care more than men, especially during the antenatal care period, or the opposite, where women are less likely to seek medical care when they have a strep throat infection; however, no clear explanation has been identified.…”

Section: Discussionmentioning

confidence: 99%

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Echocardiography Effectiveness in Improving Diagnosis of Rheumatic Heart Disease in North Darfur: A Hospital-based Study

Adam¹,

Osman²,

Abdalrasoul³

et al. 2020

Exploratory Research and Hypothesis in Medicine

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Background: Acute rheumatic fever (ARF) is an inflammatory disease caused by autoimmune responses to bacterial infection. Rheumatic heart disease (RHD) damages one or more heart valves through recurrent episodes of ARF. We aimed to determine the changes in sensitivity, specificity and predictive values in RHD Jones diagnostic guidelines following the inclusion of echocardiograph as an additional diagnostic tool for RHD. Methods: This is a retrospective cross-sectional study done in the echocardiography center of Al-Fashir teaching hospital. We included a total of 1,103 patients who presented at our hospital and had a diagnosis of RHD, ischemic heart disease or congestive heart disease during 2011-2017. Results: Among the RHD patients, screening with echocardiography was associated with increases of the sensitivity value, positive predictive value and specificity value by 18.1%, 8.1% and 1%, as compared to their initial diagnoses by Jones criteria alone, which were primarily based on clinical presentations. Mitral stenosis was the most common RHD abnormality, followed by aortic and tricuspid valve regurgitation. North Darfur state was found to have the lowest prevalence of RHD in all geographical parts of Sudan that have been studied. The female to male ratio was 3:1. Conclusions: Our data highlight the important role of echocardiography in diagnosing RHD complications through improved diagnostic sensitivity, positive predictive value and specificity.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

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Echocardiography Effectiveness in Improving Diagnosis of Rheumatic Heart Disease in North Darfur: A Hospital-based Study

Adam¹,

Osman²,

Abdalrasoul³

et al. 2020

Exploratory Research and Hypothesis in Medicine

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“…In Sudan, RHD constitutes one of the major causes of heart disease in children and young adults [1]. Recently, echocardiographic (echo) screening has shown that the prevalence is high in certain areas in Sudan as in North Kordofan (62/1,000) [2]. In Sudanese children, RHD presents to referral centres with severe valve lesions in 83% of cases where the only effective treatment is valve surgery which is often not available [3].…”

Section: Introductionmentioning

confidence: 99%

Rheumatic heart disease in North Darfur: an alarmingly high burden and control initiative

et al. 2018

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Rheumatic heart disease (RHD) is the most common cause of cardiac morbidity in Sudanese young people and it is particularly prevalent in Darfur area. A retrospective review of clinical and echocardiography (echo) data for children with RHD seen in Al Fashir Hospital from 2010 to 2016 was conducted. Data from the hospital statistics, outpatient and echo clinic records were collected and analysed. A control program was started based on training modules and public awareness material. In the study period, 324 patients were admitted and 3,777 patients with RHD were seen in outpatient clinics. Complications occurred in 33% of inpatients with a case fatality of 12%. Echo revealed that 83% of patients have severe disease and 50% have a combination of more than two valves affected. Training of 50 medical assistants, 30 physicians and 10 health promoters was achieved. Public awareness programs were conducted. We found a significant burden of RHD in Al Fashir Hospital. A control program was initiated that needs substantial support from governmental and nongovernmental organizations.

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“…Subsequently, many studies have reported HHE to be a reliable tool for screening of rheumatic heart disease (RHD) with good comparability to SE. [ 3 4 5 ] However, the use of HHE for diagnosis of congenital heart disease (CHD) has not been adequately investigated. Such utility may have an important role in remote areas as well as for sick children with suspected CHD where urgent decisions need to be made.…”

Section: Introductionmentioning

confidence: 99%

Validation of the accuracy of handheld echocardiography for diagnosis of congenital heart disease

Ali

Bushari

2018

Ann Pediatr Card

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Background:Handheld echocardiography (HHE) has been increasingly used for rheumatic heart disease screening and in adult emergency room settings.Aims:This study aimed to validate the accuracy of HHE in the diagnosis of congenital heart disease (CHD).Settings and Design Methodology:This is a prospective study carried out at three pediatric cardiology outpatient clinics in Khartoum, Sudan.All patients with suspected CHD were evaluated by clinical examination followed by HHE, performed using a modified segmental approach. Then, a complete study was performed using a standard echocardiography machine. The results were then compared using appropriate statistical tools.Results:A total of eighty cases were included with the following diagnoses either in isolation or combination: ventricular septal defect (n = 23), atrial septal defect (n = 10), pulmonary stenosis (n = 7), tetralogy of Fallot (n = 7), patent ductus arteriosus (n = 6), atrioventricular septal defect (n = 6), transposition of the great arteries (n = 6), and other diagnoses (n = 15). Agreement between HHE and SE was excellent both for visualizing heart segments (κ =77%–100% with a mean of 92.9%) and for diagnosis of CHD (κ =66%–100% with a mean of 91.7%). The sensitivity of HHE was 69.2%–100% (mean = 90.2%) and specificity was 98.5%–100% (mean = 99.3%).Conclusion:This study supports extending the utility of HHE in children for screening of CHD in addition to its current role in rheumatic heart disease screening.

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The Echocardiographic Prevalence of Rheumatic Heart Disease in North Kordofan and Initiation of a Control Program

Cited by 14 publications

References 4 publications

Echocardiography Effectiveness in Improving Diagnosis of Rheumatic Heart Disease in North Darfur: A Hospital-based Study

Echocardiography Effectiveness in Improving Diagnosis of Rheumatic Heart Disease in North Darfur: A Hospital-based Study

Rheumatic heart disease in North Darfur: an alarmingly high burden and control initiative

Validation of the accuracy of handheld echocardiography for diagnosis of congenital heart disease

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