Prevalence of rheumatic valvular heart disease in Rwandan school children: echocardiographic evaluation using the World Heart Federation criteria

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Rheumatic heart disease (n=2501). Intervention: Echocardiographic screening (2012 WHF criteria). Primary outcome: Prevalence of rheumatic heart disease (per 1000 children) (95% CI 4.2-10.9).

Joseph Mucumbitsi; Bernard E. Bulwer; Léon Mutesa; Vedaste Ndahindwa; Muhammed Semakula; Emmanuel Rusingiza; Puneeta Arya; Suellen Breakey; Ceeya Patton‐Bolman; Edward L. Kaplan

doi:10.5830/cvja-2017-007

October 27, 2017Cardiovascular journal of South Africa/Cardiovascular journal of Southern AfricaOpen Access

Prevalence of rheumatic valvular heart disease in Rwandan school children: echocardiographic evaluation using the World Heart Federation criteria

View Full Paper

Ask AI

Bookmark

Share

Key result

Echocardiographic screening of Rwandan school children using the 2012 World Heart Federation criteria revealed a rheumatic heart disease prevalence of 6.8 per 1,000 children.

Figures

Key Points

To determine the prevalence of rheumatic valvular heart disease among Rwandan school children using the 2012 World Heart Federation echocardiographic criteria.
Conducted echocardiographic evaluations in a randomly selected sample of N=2,501 school children across 10 schools in the Gasabo district near Kigali, Rwanda.
Assessed imaging findings using four experienced echocardiographers following the 2012 World Heart Federation (WHF) criteria.
Identified an overall rheumatic heart disease prevalence of 6.8 per 1,000 children (95% CI: 4.2/1,000–10.9/1,000).
Detected 17 children meeting WHF criteria, including 13 cases of borderline RHD and 4 cases of definite RHD, none of whom were previously diagnosed.

Study Design

Type

Cross-Sectional (n=2,501)

Blinding

Single-blind (echocardiogram readers blinded to demographic data)

Multicenter

Yes

Structured PICO

P

Population

2,501 randomly selected school children (ages 6-20, mean age 11.2 years) from 10 schools in the Gasabo district near Kigali, Rwanda.

I

Intervention

Echocardiographic screening using the 2012 World Heart Federation (WHF) criteria.

O

Outcome

Prevalence of rheumatic heart disease (RHD) defined by 2012 WHF criteria (definite or borderline).surrogate

Echocardiographic screening reveals a significant burden of previously undiagnosed rheumatic heart disease (6.8 per 1,000) among school children in Rwanda, highlighting the need for public health control programs.

Limitations

The selected sample from a single district near the capital may not be representative of all similar-age school children in Rwanda.
The smaller percentage of relatively older children in the examined sample may have unintentionally affected the calculated overall prevalence.
Echocardiographic equipment from different manufacturers and different transducers were used.
Lack of long-term prospective follow-up to confirm the diagnosis, especially for borderline cases.
Selecting a district closer to the capital could have introduced bias.
Smaller percentage (9%) of relatively older children in the examined sample may have unintentionally affected the calculated overall prevalence.
Echocardiographic equipment from different manufacturers was used, and the same pediatric transducers were not universally used for all subjects.

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Indicates substantial undiagnosed RHD burden in Rwandan children; leaves open optimal screening strategies pending prospective studies.

Abstract

BACKGROUND: Rheumatic fever (RF) and rheumatic valvular heart disease (RHD) remain important medical, surgical and public health concerns in many parts of the world, especially in sub-Saharan Africa. However, there are no published data from Rwanda. We performed a RHD prevalence study in a randomly selected sample of Rwandan school children using the 2012 World Heart Federation (WHF) criteria. METHODS: Echocardiographic assessment of 2 501 Rwandan school children from 10 schools in the Gasabo district near Kigali was carried out. Resulting data were evaluated by four experienced echocardiographers. Statistical analyses were carried out by statisticians. RESULTS: RHD prevalence was 6.8/1 000 children examined (95% CI: 4.2/1 000-10.9/1 000). Seventeen met WHF criteria for RHD, 13 fulfilled criteria for 'borderline' RHD and four were 'definite' RHD. None of these 17 had been previously identified. CONCLUSION: These data indicate a significant burden of RHD in Rwanda and support a need for defined public health RF control programmes in children there.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Mucumbitsi et al. (2017) conducted a cross-sectional in Rheumatic heart disease (n=2,501). Echocardiographic screening (2012 WHF criteria) was evaluated on Prevalence of rheumatic heart disease (per 1000 children) (95% CI 4.2-10.9). Echocardiographic screening of Rwandan school children using the 2012 World Heart Federation criteria revealed a rheumatic heart disease prevalence of 6.8 per 1,000 children.

synapsesocial.com/papers/6a1acd9b4dcca2706385c105 https://doi.org/10.5830/cvja-2017-007

View Full Paper

Ask AI

Bookmark

Share

Prevalence of rheumatic valvular heart disease in Rwandan school children: echocardiographic evaluation using the World Heart Federation criteria

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Prevalence of rheumatic valvular heart disease in Rwandan school children: echocardiographic evaluation using the World Heart Federation criteria

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading