Key result
A national screening program of 107,340 school-attending Nepalese children found an overall Rheumatic Heart Disease prevalence of 2.22 cases per 1000 (95% CI: 1.94-2.50).
Why the study?
Rheumatic heart disease is a major public health problem in lower-middle income countries, but a nation-wide database was lacking in Nepal to design effective prevention and control strategies.
What is the prevalence of Rheumatic Heart Disease in school-attending Nepalese children?
Cross-Sectional (n=107,340)
Yes
What is the prevalence of Rheumatic Heart Disease in school-attending Nepalese children?
The prevalence of rheumatic heart disease among school-attending children in Nepal is 2.22 per 1000, highlighting the need for targeted prevention programs in high-prevalence regions.
Answers are grounded in this paper and cite their sources.
Informs RHD burden estimates in Nepalese children; leaves open optimal prevention strategies in high-prevalence zones.
OBJECTIVE: Rheumatic Heart Disease (RHD) remains a significant public health problem with high morbidity and mortality in children and young adults from lower-middle income countries like Nepal. However, a nation-wide database of the disease is lacking for designing effective future prevention and control programmes and strategies. The aim of our study is to estimate the prevalence of RHD in school-attending Nepalese children. METHODS: We performed a cross-sectional descriptive analysis of a nationally representative database of Nepal Heart Foundation (NHF) national RHD screening programme which included school-attending Nepalese children between five and sixteen years of age. The screening was conducted between May 2015 and March 2020 in 236 schools, representing all seven provinces, across all three ecological zones of Nepal. Transthoracic two-dimensional echocardiography was performed in all eligible children with more than grade one murmur on cardiac auscultation. We estimated the prevalence of RHD among school-attending children as the number of RHD cases per 1000 school-attending children with a 95% confidence interval. RESULTS: The database included a total of 107,340 children who were screened clinically, of whom 10,600 (9·9%) underwent transthoracic two-dimensional echocardiography. The overall prevalence of RHD was 2.22 cases per 1000 school-attending children (95% CI:1·94 - 2·50). The highest prevalence was observed among children living in the southern Terai ecological zone (2·89 per 1000, 95% CI (2·32-3·46)) of Nepal. Among the provinces, Karnali had the highest prevalence of RHD (3·45 per 1000, 95% CI (2·42-4·48)). Among the districts screened, Kalikot had the highest RHD prevalence (5.47 per 1000, 95% CI (3.02-7.92)). CONCLUSION: Primordial, primary and secondary prevention programmes should pay special attention to southern Terai zone, particularly the under-privileged children from remote districts.
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Regmi et al. (2023) conducted a cross-sectional in Rheumatic Heart Disease (n=107,340). National RHD screening programme was evaluated on Prevalence of RHD among school-attending children (cases per 1000) (95% CI 1.94-2.50). A national screening program of 107,340 school-attending Nepalese children found an overall Rheumatic Heart Disease prevalence of 2.22 cases per 1000 (95% CI: 1.94-2.50).
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