P5442Prevalence and prognostic value of echocardiographic screening for RHD in Aswan school children

Introduction: Rheumatic heart disease (RHD) remains an important public health problem in many low and middle income countries, where it is one of the most frequent causes of heart disease especially in young people. A number of echocardiographic screening studies carried out in children and young adults have suggested that subclinical RHD is far more widespread than may be detected clinically. However, there is still uncertainty as to the prognostic significance of subclinical disease detected in this way and consequently whether echocardiographic screening programs could be a valuable tool for the early detection of clinically important disease. Purpose: The aim of this study was to perform systematic echocardiographic screening for RHD in a large sample of schoolchildren in Aswan to determine its prevalence, severity and form of valvular disease and, in a follow-up study, to evaluate how these findings changed up to five years later. Methods: A systematic cross-sectional echocardiographic screening study was performed in 3062 randomly selected schoolchildren, aged 5 to 15 years, in Aswan, Egypt. The diagnosis of RHD was based on the current WHF criteria and the images obtained were reviewed by two senior cardiologists. Follow-up of children with a definite or possible diagnosis of RHD together and a control group of 80 normal children was carried out 48 to 60 months later using the same techniques.