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High prevalence of rheumatic heart disease by clinical and echocardiographic screening among children in Fiji

Steer, A., Kado, J., Wilson, N., Tuiketei, T., Batzloff, M., Waqatakirewa, L, Mulholland, E. Kim and Carapetis, Jonathan (2009). High prevalence of rheumatic heart disease by clinical and echocardiographic screening among children in Fiji. The Journal of Heart Valve Disease,18(3):327-335.

Document type: Journal Article

IRMA ID 10666xPUB25
Title High prevalence of rheumatic heart disease by clinical and echocardiographic screening among children in Fiji
Author Steer, A.
Kado, J.
Wilson, N.
Tuiketei, T.
Batzloff, M.
Waqatakirewa, L
Mulholland, E. Kim
Carapetis, Jonathan
Journal Name The Journal of Heart Valve Disease
Publication Date 2009
Volume Number 18
Issue Number 3
ISSN 0966-8519   (check CDU catalogue open catalogue search in new window)
Start Page 327
End Page 335
Total Pages 9
Place of Publication UK
Publisher ICR Publishers Ltd
HERDC Category C1 - Journal Article (DEST)
Abstract Background and aim of the study: Rheumatic heart disease (RHD) is an important cause of morbidity and mortality in young people in developing countries. Many cases of RHD are first detected when they progress to cardiac failure. Screening for RHD represents a means of detecting cases early so that preventative measures to halt the disease progression can be put into place.

Methods: A cross-sectional screening survey of RHD in 3,462 children aged 5 to 15 years in Fiji was performed in 2006. A three-stage screening method was used: stage 1 involved auscultatory screening; stage 2 was a limited echocardiography of children identified as having a suspicious murmur in stage 1; and stage 3 involved a full echocardiography of children identified as having pathology in stage 2.

Results: Among the 3,462 children screened, 359 (10.4%) had a significant murmur; subsequent echocardiography was performed on 331 of these children, with RHD being detected in 29 cases. The prevalence of definite RHD was 4.1 per 1,000 (95% CI 2.2-6.8), and the overall prevalence (definite or probable RHD) was 8.4 cases per 1,000 (95% CI 5.6-12).

Conclusion: The study results suggest that there is a significant burden of undetected RHD in Fiji. The three-stage approach described here represents a practical means of screening for clinical RHD in developing countries, although it does not allow detection of the subclinical disease.
Keywords rheumatic heart disease
echocardiographic screening
clinical screening
children
Fiji
 
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Created: Thu, 25 Mar 2010, 12:10:47 CST