Prevalence of rheumatic heart disease in Zambian school children

被引:12
|
作者
Schwaninger, Sherri [1 ]
Musuku, John [2 ]
Engel, Mark E. [3 ,4 ]
Musonda, Patrick [5 ]
Lungu, Joyce Chipili [2 ]
Machila, Elizabeth [2 ]
Mtaja, Agnes [2 ]
Mulendele, Evans [2 ]
Kavindele, Dorothy [2 ]
Spector, Jonathan [6 ]
Tadmor, Brigitta [7 ]
Gutierrez, Marcelo M. [8 ]
Van Dam, Joris [9 ]
Colin, Laurence [9 ]
Long, Aidan [10 ]
Fishman, Mark C. [11 ]
Mayosi, Bongani M. [3 ,4 ]
Zuhlke, Liesl J. [12 ,13 ]
机构
[1] Novartis Inst BioMed Res Inc, 220 Massachusetts Ave,542B, Cambridge, MA 02139 USA
[2] Univ Teaching Hosp, Dept Paediat & Child Hlth, Lusaka, Zambia
[3] Groote Schuur Hosp, Dept Med, Cape Town, South Africa
[4] Univ Cape Town, Cape Town, South Africa
[5] Univ Zambia, Sch Publ Hlth, Lusaka, Zambia
[6] Novartis Inst BioMed Res, Global Hlth, Cambridge, MA USA
[7] Novartis Inst BioMed Res, Cambridge, MA USA
[8] Novartis Inst BioMed Res, Global Hlth, Basel, Switzerland
[9] Novartis Inst BioMed Res, Global Drug Dev, Cambridge, MA USA
[10] Massachusetts Gen Hosp, Dept Allergy & Clin Immunol, Boston, MA 02114 USA
[11] Harvard Univ, Harvard Dept Stem Cell & Regenerat Biol, Cambridge, MA 02138 USA
[12] Red Cross War Mem Childrens Hosp, Dept Paediat, Cape Town, South Africa
[13] Univ Cape Town, Dept Med, Cape Town, South Africa
来源
关键词
Rheumatic heart disease; Rheumatic fever; Screening; Cardiovascular disease; Control strategies; Epidemiology; Echocardiography; Zambia; Prevalence; Streptococcal pharyngitis; BENZATHINE PENICILLIN; ECHOCARDIOGRAPHY; PREVENTION; FEVER; OUTCOMES; REGISTRY; AFRICA; BURDEN;
D O I
10.1186/s12872-018-0871-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The large global burden of rheumatic heart disease (RHD) has come to light in recent years following robust epidemiologic studies. As an operational research component of a broad program aimed at primary and secondary prevention of RHD, we sought to determine the current prevalence of RHD in the country's capital, Lusaka, using a modern imaging-based screening methodology. In addition, we wished to evaluate the practicality of training local radiographers in echocardiography screening methods. Methods: Echocardiography was conducted on a random sample of students in 15 schools utilizing a previously validated, abbreviated screening protocol. Through a task-shifting scheme, and in the spirit of capacity-building to enhance local diagnostic and research skills, general radiographers based at Lusaka University Teaching Hospital (UTH) were newly trained to use portable echocardiography devices. Students deemed as screen-positive were referred for comprehensive echocardiography and clinical examination at UTH. Cardiac abnormalities were classified according to standard World Heart Federation criteria. Results: Of 1102 students that were consented and screened, 53 students were referred for confirmatory echocardiography. Three students had definite RHD, 10 had borderline RHD, 29 were normal, and 11 students were lost to follow-up. The rates of definite, borderline, and total RHD were 2.7 per 1000, 9.1 per 1000, and 11.8 per 1000, respectively. Anterior mitral valve leaflet thickening and chordal thickening were the most common morphological defects. The pairwise kappa test showed fair agreement between the local radiographers and an echocardiographer quality assurance specialist. Conclusion: The prevalence of asymptomatic RHD in urban communities in Zambia is within the range of results reported in other sub-Saharan African countries using the WHF criteria. Task-shifting local radiographers to conduct echocardiography was feasible. The results of this study will be used to inform ongoing efforts in Zambia to control and eventually eliminate RHD.
引用
收藏
页数:12
相关论文
共 50 条
  • [1] Prevalence of rheumatic heart disease in Zambian school children
    John Musuku
    Mark E. Engel
    Patrick Musonda
    Joyce Chipili Lungu
    Elizabeth Machila
    Sherri Schwaninger
    Agnes Mtaja
    Evans Mulendele
    Dorothy Kavindele
    Jonathan Spector
    Brigitta Tadmor
    Marcelo M. Gutierrez
    Joris Van Dam
    Laurence Colin
    Aidan Long
    Mark C. Fishman
    Bongani M. Mayosi
    Liesl J. Zühlke
    [J]. BMC Cardiovascular Disorders, 18
  • [2] Prevalence of Rheumatic Heart Disease in Denver School Children
    Wedum, Bernice G.
    Wedum, Arnold G.
    Beaghler, A. L.
    [J]. AMERICAN JOURNAL OF PUBLIC HEALTH AND THE NATIONS HEALTH, 1945, 35 (12): : 1271 - 1276
  • [3] PREVALENCE OF RHEUMATIC HEART DISEASE IN DENVER SCHOOL CHILDREN
    WEDUM, BG
    WEDUM, AG
    BEAGHLER, AL
    [J]. AMERICAN JOURNAL OF PUBLIC HEALTH, 1945, 35 (12) : 1271 - 1276
  • [4] Prevalence of rheumatic heart disease in school children of urban Lahore
    Sadiq, M.
    Islam, K.
    Abid, R.
    Latif, F.
    Rehman, A. U.
    Waheed, A.
    Azhar, M.
    Khan, J. S.
    [J]. HEART, 2009, 95 (05) : 353 - 357
  • [5] PREVALENCE OF RHEUMATIC HEART DISEASE IN PUERTO RICAN SCHOOL CHILDREN
    SHEFFERMAN, MM
    GOODMAN, JS
    AIXALA, RA
    [J]. PUBLIC HEALTH REPORTS, 1966, 81 (03): : 289 - +
  • [6] Prevalence of rheumatic heart disease among school children in Addis Ababa
    Oli, K
    Porteous, J
    [J]. EAST AFRICAN MEDICAL JOURNAL, 1999, 76 (11) : 601 - 605
  • [7] High Prevalence of Rheumatic Heart Disease Detected by Echocardiography in School Children
    Bhaya, Maneesha
    Panwar, Sadiak
    Beniwal, Rajesh
    Panwar, Raja Babu
    [J]. ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2010, 27 (04): : 448 - 453
  • [8] PREVALENCE OF RHEUMATIC HEART-DISEASE IN DELHI SCHOOL-CHILDREN
    SHRESTHA, NK
    PADMAVATI, S
    [J]. INDIAN JOURNAL OF MEDICAL RESEARCH, 1979, 69 (MAY) : 821 - 833
  • [9] Screening for the prevalence of rheumatic heart disease among school children in Egypt
    Fareed, Ahmed
    Saleh, Omar
    Maklady, Fathy
    [J]. ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2023, 40 (06): : 494 - 499
  • [10] Prevalence of rheumatic heart disease among school-children in Aden, Yemen
    Ba-Saddik, I. A.
    Munibari, A. A.
    Al-Naqeeb, M. S.
    Parry, C. M.
    Hart, C. A.
    Cuevas, L. E.
    Coulter, J. B. S.
    [J]. ANNALS OF TROPICAL PAEDIATRICS, 2011, 31 (01): : 37 - 46