What a High Prevalence of Rheumatic Heart Disease in Sickle Cell Patients

ObjectiveEstimates of the prevalence of rheumatic heart disease (RHD) in many endemic countries are limited to samples of children attending schools, which generate an incomplete picture of disease burden in communities. The present study conducted household-based RHD screening in a representative community in Gulu district, Uganda.MethodsMembers of households identified through a two-stage cluster-sampling approach between the ages of 5 years and 50 years were invited to undergo limited cardiac testing with a handheld echocardiogram to assess for the presence of RHD. Suspicious cases underwent confirmatory echocardiogram with a fully functional machine.ResultsOf the 2453 community members screened, 2.45% (95% CI 1.87% to 3.14%) showed echocardiographic evidence of RHD with 1.26% (95% CI 0.860% to 1.79%) having definite RHD. The overall prevalence of RHD among participants <20 years was 2.52% (95% CI 1.78% to 3.45%), with a borderline prevalence of 1.97% (95% CI 1.33% to 2.82%) and a definite prevalence of 0.544% (95% CI 0.235% to 1.07%). Prevalence rates among youth increased with age and peaked in the age group of 16–20 years. The overall adult prevalence (>20 years) of RHD was 2.34% (95% CI 1.49% to 3.49%). The majority of definite cases were mild (81%) and marked by mitral regurgitation and associated morphological valve changes (71%).ConclusionOur data reveal a high prevalence of undiagnosed RHD within an endemic community and fill a critical gap in RHD epidemiology in African adults.

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HIGH PREVALENCE OF RHEUMATIC HEART DISEASE IN 2603 SCHOOL CHILDREN IN NORTH-WEST INDIA WITH 6 MONTHS AND 2 YEARS FOLLOW-UP: AN ECHOCARDIOGRAPHIC SURVEY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(19)32631-2 ◽

2019 ◽

Vol 73 (9) ◽

pp. 2025

Author(s):

Raja Babu Panwar ◽

Bal Kishan Gupta ◽

Arvind Kumar Sharma ◽

Dinesh Choudhary ◽

Sadik Panwar ◽

...

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

School Children ◽

North West ◽

High Prevalence ◽

Rheumatic Heart

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THE COEXISTENCE OF RHEUMATIC HEART DISEASE AND SICKLE CELL ANEMIA

The American Journal of the Medical Sciences ◽

10.1097/00000441-196310000-00012 ◽

1963 ◽

Vol 246 (4) ◽

pp. 462-470 ◽

Cited By ~ 4

Author(s):

Namik Kemal Uzsoy

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

Sickle Cell ◽

Sickle Cell Anemia ◽

Rheumatic Heart

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High prevalence of rheumatic heart disease in schoolchildren detected by echocardiography screening in New Caledonia

Journal of Paediatrics and Child Health ◽

10.1111/jpc.12087 ◽

2013 ◽

Vol 49 (2) ◽

pp. 109-114 ◽

Cited By ~ 18

Author(s):

Noémie Baroux ◽

Bernard Rouchon ◽

Bertrand Huon ◽

Agnès Germain ◽

Jean-Michel Meunier ◽

...

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

New Caledonia ◽

High Prevalence ◽

Rheumatic Heart

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Incidence of sickle cell anemia with rheumatic heart disease

The Journal of Pediatrics ◽

10.1016/s0022-3476(48)80055-7 ◽

1948 ◽

Vol 33 (2) ◽

pp. 186-189 ◽

Cited By ~ 3

Author(s):

Irving Robert Ohrenstein

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

Sickle Cell ◽

Sickle Cell Anemia ◽

Rheumatic Heart

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High prevalence of tricuspid valve disease among rheumatic heart disease patients in Yemen

Journal of the Saudi Heart Association ◽

10.1016/j.jsha.2013.03.159 ◽

2013 ◽

Vol 25 (2) ◽

pp. 164

Author(s):

Sameera Al.Rajwi ◽

Ahmed Al-Motarreb ◽

Nouraddin Aljaber ◽

Aziz Alzendani

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

Tricuspid Valve ◽

Valve Disease ◽

High Prevalence ◽

Rheumatic Heart

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A rapid echocardiographic screening protocol for rheumatic heart disease in Samoa: a high prevalence of advanced disease

Cardiology in the Young ◽

10.1017/s1047951117000907 ◽

2017 ◽

Vol 27 (8) ◽

pp. 1599-1605 ◽

Cited By ~ 2

Author(s):

Marvin Allen ◽

John Allen ◽

Take Naseri ◽

Rebecca Gardner ◽

Dennis Tolley ◽

...

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

Advanced Disease ◽

Valve Disease ◽

Severe Aortic Regurgitation ◽

Time Period ◽

High Prevalence ◽

The World ◽

Screening Protocol ◽

Rheumatic Heart

AbstractBackgroundEchocardiography has been proposed as a method to screen children for rheumatic heart disease. The World Heart Federation has established guidelines for echocardiographic screening. In this study, we describe a rapid echocardiogram screening protocol according to the World Heart Federation guidelines in Samoa, endemic for rheumatic heart disease.MethodsWe performed echocardiogram screening in schoolchildren in Samoa between 2013 and 2015. A brief screening echocardiogram was performed on all students. Children with predefined criteria suspicious for rheumatic hear diseases were referred for a more comprehensive echocardiogram. Complete echocardiograms were classified according to the World Heart Federation guidelines and severity of valve disease.ResultsEchocardiographic screening was performed on 11,434 children, with a mean age of 10.2 years; 51% of them were females. A total of 558 (4.8%) children underwent comprehensive echocardiography, including 49 students who were randomly selected as controls. Definite rheumatic heart disease was observed in 115 students (10.0 per 1000): 92 students were classified as borderline (8.0 per 1000) and 23 with CHD. Advanced disease was identified in 50 students (4.4 per 1000): 15 with severe mitral regurgitation, five with severe aortic regurgitation, 11 with mitral stenoses, and 19 with mitral and aortic valve disease.ConclusionsWe successfully applied a rapid echocardiographic screening protocol to a large number of students over a short time period – 28 days of screening over a 3-year time period – to identify a high prevalence of rheumatic heart disease. We also reported a significantly higher rate of advanced disease compared with previously published echocardiographic screening programmes.

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