Heart Disease Screening of School Children : By using improved computer system for heart sound and electrocardiogram : PROCEEDINGS OF THE III. CONFERENCE ON PREVENTION FOR RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE

This joint report of the Committees on School Health and Rheumatic Fever of the American Academy of Pediatrics has been prepared as a guide to school authorities in determining what can be done about this disease through the schools. The school occupies a unique position in relation to rheumatic fever control. Rheumatic fever causes more deaths than any other disease in children of school age. A first attack usually occurs in children at the age when they are in the first or second grade and recurrences are most common up to the age when children are leaving high school. The insidious onset of so many cases during the school years suggests that teachers and others in daily contact with school children should be aware of early signs and symptoms which may mean acute rheumatic fever. The periodic school health examination when done hastily without removal of clothing may miss children with rheumatic heart disease. On the other hand, children may be labeled with the diagnosis of a rheumatic heart because a heart murmur Was wrongly interpreted. This serves to emphasize the opportunities as well as the difficulties of discovering rheumatic fever and rheumatic heart disease in school children. Improvement of School Medical Procedures The American Academy of Pediatrics believes the problem of what to do about rheumatic fever through the schools is an integral part of what should be done about the health of all school children. The following recommendations, while pointed towards case-finding and health supervision of the rheumatic child, will, if applied, lead to better health service for all school children. The periodic school medical examination should be improved: 1. By obtaining a health history of the child from the parent and the teacher, if possible, at the time of the child's examination. 2. By being performed without haste and with the child disrobed. 3. By the employment of physicians trained in pediatrics, if possible. Where this is not feasible, arrangements should be made for giving physicians who make school medical examinations additional clinical training in normal child growth and development as well as in children's medical problems including rheumatic fever and heart disease. 4. By allowing time for the physicians to plan with the nurse and parent for medical attention. The examination is then more likely to be of greater aid in getting medical care for school children who need it.

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P3129Rheumatic heart diseases screening in Bornean Malaysia: a pilot echocardiography study

European Heart Journal ◽

10.1093/eurheartj/ehz745.0204 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

J H Foo ◽

W L Chong ◽

M O H D Azizan Bin Abdullah ◽

C H Yen ◽

S F Liew ◽

...

Keyword(s):

Heart Disease ◽

Early Detection ◽

Primary School ◽

Diagnostic Criteria ◽

Rheumatic Heart Disease ◽

School Children ◽

Disease Screening ◽

Primary School Students ◽

School Students ◽

Rheumatic Heart

Abstract Background Rheumatic heart disease is a major public health issue in developing countries including Malaysia. RHD is a preventable disease. Early detection and appropriate treatment may decrease the disease burden to the society. Rheumatic heart disease screening using portable echocardiography may improve early detection among school children in vulnerable community. This is a pilot study of rheumatic heart disease screening using Vscan among primary school students in the Bornean state of Sabah Malaysia. Purpose To evaluate the resources required for RHD screening, prevalence of RHD among school children and awareness among the parents and teachers. Methods A cohort of 211 students from a primary school were recruited in 2017–2018. Parental consents were obtained. Seven sessions were conducted at the school. Echocardiography was performed by 2–3 experienced ultrasonographers. Image interpretation as per the 2012 WHF RHD echocardiographic diagnostic criteria. Results Of the 211 students, 50% female, age range 7–12 year-old. Ethnic groups include Kadazandusun (87%), Rungus (2.4%), Lundayeh (2%), Chinese (2%). Overall, the average number of student scanned was 4.6 students/device/hour. There was a learning curve observed, whereby initial session only scanned 2 students/device/hour which improved to a maximum of 5.9 students/device/hour. Preliminary findings noted probable RHD among 36% (n=76) of screened subjects. Incidental diagnosis of congenital heart disease among 5 students. The suspected RHD cases were referred for formal echocardiography in the tertiary centre for confirmation. Thus far, 12 students were diagnosed with borderline RHD; the main diagnostic criteria in these cases were at least two morphological features of RHD of the MV without pathological MR or MS. Secondary prophylaxis with antibiotic, dental hygiene and patient education were given. Conclusion This is a pilot RHD screening using portable Vscan echocardiography among primary school students in Malaysia. Our study showed it is feasible to conduct RHD screening in the field using portable Vscan. The number of students screened improved with practice. Our preliminary finding suggest RHD is prevalent in this population in Sabah, Malaysia.

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Epidemiological survey of Rheumatic fever, Rheumatic heart disease and Congenital heart disease among school children in Kathmandu valley of Nepal

Nepalese Heart Journal ◽

10.3126/njh.v10i1.9738 ◽

2014 ◽

Vol 10 (1) ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Dipanker Prajapati ◽

Deewakar Sharma ◽

Prakash Raj Regmi ◽

Harihar Khanal ◽

Sajan Gopal Baidya ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Public Schools ◽

Rheumatic Fever ◽

Rheumatic Heart Disease ◽

School Children ◽

Congenital Heart ◽

Epidemiological Survey ◽

Kathmandu Valley ◽

Rheumatic Heart

Background and Aims: Rheumatic Fever, Rheumatic Heart Disease and Congenital Heart disease are the most common cardiac problems in school children. Prior studies have reported different prevalence rate of Rheumatic Heart Disease among different groups of population of Nepal. The aim of this study was to estimate the prevalence of Rheumatic Fever, Rheumatic Heart Disease and Congenital Heart Disease among school children in Kathmandu Valley of Nepal. Methods: Cardiac screening of 34,876 school children from 115 randomly selected public schools from two cities of Kathmandu Valley (Kathmandu and Lalitpur) was done. Cases with abnormal findings in auscultation underwent echocardiography and the diagnosis was confirmed. Results: The prevalence of Congenital Heart Disease was noted to be 1 per thousand and prevalence of Rheumatic Heart Disease was found to be 0.90 per thousand (in the age group 5-16 years) with the most common lesion being Mitral Regurgitation. No significant statistical difference was noted between male and female students in both the cases of Rheumatic Heart Disease and Congenital Heart Disease. No cases of Acute Rheumatic Fever were noted. Conclusion: The prevalence of Rheumatic Heart Disease among school children in Kathmandu valley was noted to be lower than reported in similar previous studies. Primary and secondary prevention programs of RF/RHD have been effective in Nepal and are needed to be strengthened and expanded to further reduce the burden of these diseases. Nepalese Heart Journal | Volume 10 | No.1 | November 2013| Pages 1-5 DOI: http://dx.doi.org/10.3126/njh.v10i1.9738

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