Prevalence of rheumatic heart disease in school going children of Meghalaya - An echocardiographic study from Northeast of India

OBJECTIVE: The lack of data related to the prevalence of rheumatic heart disease (RHD) in Meghalaya, India prompted us to assess the prevalence of RHD in school-going children of Meghalaya aged 5-15 years and risk factors associated with it. METHODS: A cross-sectional epidemiological study was performed using World Heart Federation (WHF) echocardiographic criteria with a portable echo machine. RESULTS: 4039 children (mean age 10.18 ± 2.87 years) underwent 2D echocardiographic screening. Among them, 2100 (52.0 %) were aged 5-10 years and 1939 (48.0 %) were aged 11-15 years. Of them, 2066 (51.1 %) were female and 2488 (61.6 %) resided in rural areas. 652 (16.1 %) children were in government-run schools, 1836 (45.5 %) in private institutions. The cohort's mean BMI was 16.94 ± 2.52. Ethnically, 3818 children (94.5 %) belonged to indigenous tribes-Khasi (61.9 %), Jaintia (21.7 %), and Garo (10.9 %)-while 221 (5.5 %) were from non-native groups. Echocardiography identified subclinical RHD in 19 children (4.7 per 1000) and clinical RHD in 2 children (0.49 per 1000). Among subclinical cases, 8 were classified as definite RHD (1.98 per 1000) and 11 as borderline RHD (2.72 per 1000). RHD risk increased with age (OR = 1.16; 95 % CI: 0.98-1.37), was approximately twofold higher in females (OR = 2.07; 95 % CI: 0.79-5.47), and was more prevalent among rural children and those attending government schools. CONCLUSION: Subclinical RHD prevalence in Meghalaya's children is significantly higher than clinical RHD. These findings highlight the need for a national registry to monitor subclinical cases and evaluate the impact of future interventions.