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Prevalence of Rheumatic Heart Disease Detected by Echocardiographic Screening Among School Children in the Niger Delta Region of Nigeria
Current Issue
Volume 7, 2019
Issue 2 (June)
Pages: 52-58   |   Vol. 7, No. 2, June 2019   |   Follow on         
Paper in PDF Downloads: 9   Since Jun. 27, 2019 Views: 109   Since Jun. 27, 2019
Authors
[1]
Ujuanbi Amenawon Susan, Department of Paediatrics, Federal Medical Centre, Yenagoa, Nigeria.
[2]
Tabansi Petronilla Nnena, Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
[3]
Otaigbe Barbara Edewele, Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Abstract
Rheumatic heart disease (RHD) is an important public health problem in developing countries. Community-based studies using portable echocardiography have enhanced detection of RHD for early intervention. The aim of this study was to determine the prevalence of RHD among school children in Port Harcourt, the pattern of valvular involvement (s), the relationship of RHD with certain risk factors (such as overcrowding and socioeconomic status) and to ascertain the sensitivity, specificity and positive predictive value of cardiac auscultation in detecting RHD. A total of 461 students aged 5-15 years were selected by multi-staged sampling from thirteen schools in Port Harcourt. Questionnaires were used to obtain relevant information on history suggestive of rheumatic fever or RHD and parents’ occupation and level of education. Subsequently, all the selected students had cardiac auscultation and echocardiographic examination. Ethical clearance was obtained from the Research and Ethics Committee of the University of Port Harcourt Teaching Hospital and from Rivers State Ethical Committee. The study revealed an RHD prevalence rate of 4.3 per 1,000 students using cardiac auscultation and 6.5 per 1,000 students using echocardiography only. All (100%) of the affected students with RHD were within the age category of 11-15 years and were females. Mitral regurgitation (66.7%) was the commonest valvular lesion seen. There was significant association between RHD and overcrowding (p = 0.04), while 66.7% belonged to the middle socioeconomic class (SEC) and 33.3% to the low SEC. Cardiac auscultation is 66.7% sensitive and 98.7% specific in detecting RHD with a positive predictive value of 25% when compared with echocardiography. This study shows that RHD is a problem among school children within the study area. It is recommended that community screening of children for RHD using echocardiography for early detection and treatment should be undertaken to advert complications and improve the quality of life of the affected individuals.
Keywords
Rheumatic Heart Disease, Prevalence, Echocardiography, Screening
Reference
[1]
World Health Organisation. Rheumatic fever and rheumatic heart disease: report of a WHO Expert Consultation, Geneva, 29 October- 1 November 2001. Geneva, Switzerland: World Health Organisation Bulletin; 2004.
[2]
Omokhodion SI. Management of patients with rheumatic fever and rheumatic heart disease in Nigeria - need for a national system of primary, secondary and tertiary Prevention. S Afr Med J 2006; 96: 237–9.
[3]
Deen JL, Vos T, Huttly SR, Tulloch J. Injuries and non-communicable diseases: emerging health problems of children in developing countries. Bull World Health Organ 1999; 77 (6): 518-24.
[4]
Seckeler MD, Hoke TR. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. Clin Epidemiol 2011; 3: 67–84.
[5]
Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis 2005; 5 (11): 685–94.
[6]
Bode-Thomas F. Overcoming challenges in the management of structural heart diseases in Nigerian children. J Med Trop 2011; 13: 54-6.
[7]
Jaiyesimi F. Chronic rheumatic heart disease in childhood: its cost and economic implications. Trop Cardio 1982; 8: 55-7.
[8]
Ba-Saddik IA, Munibari AA, Al-Naqeeb MS, Parry CM, Hart CA, Ceuvas LE et al. Prevalence of rheumatic heart disease among school-children, Adem, Yemen. Ann Trop Paediatr 2011; 31 (1): 37-46.
[9]
Mclaren MJ, Hawkins DM, Koormhof HJ, Bloom KR, Bramwell-Jones DM, Cohen E et al. Epidemiology of rheumatic heart disease in black schoolchildren of Soweto, Johannesburg. Br Med J 1975; 3 (5981): 474-8.
[10]
Adanja B, Vlajinac H, Jarebinski M. Socioeconomic factors in the etiology of rheumatic fever. J Hyg Epidemiol Microbiol Immunol 1988; 32 (3): 329–35.
[11]
Longo-Mbenza B, Bayekula M, Ngiyulu R, Kintoki VE, Bikangi NF, Seghers KV et al. Survey of rheumatic heart disease in school children of Kinshasa town. Int J Cardiol 1998; 63 (3): 287–94.
[12]
Nandi S, Kumar R, Ray P, Vohra H, Ganguly NK. Group A streptococcal sore throat in a periurban population of northern India: a one-year prospective study. Bull World Health Organ 2001; 79 (6): 528–33.
[13]
Beaton A, Okello E, Lwabi P, Mondo C, McCarter R, Sable C. Echocardiography screening for rheumatic heart disease in Ugandan school children. Circulation 2012; 125 (25): 3127-32.
[14]
Robertson KA, Volmink JA, Mayosi BM. Towards a uniform plan for the control of rheumatic fever and rheumatic heart disease in Africa - the Awareness, Surveillance, Advocacy, and Prevention (A. S. A. P) programme. S Afr Med J 2006; 96 (3): 241-5.
[15]
Danbauchi SS, Alhassan MA, David SO, Wammanda R, Oyati IA. Spectrum of rheumatic heart disease in Zaria, northern Nigeria. Ann Afr Med 2004; 3: 17-21.
[16]
Sani MU, Karaye KM, Borodo MM. Prevalence and pattern of rheumatic heart disease in Nigeria savannah: an echocardiographic study. Cardiovasc J Afr 2007; 18 (5): 295-9.
[17]
Miller RA, Stamler J, Smith JM, Milne WS, Paul MH, Abrams I et al. The detection of heart disease in children: results of mass field trials with tape recorded heart sounds. 11. The Michigan City study. Circulation 1965; 32: 956-65.
[18]
Marijon E, Ou P, Celermajer DS, Ferreira B, Mocumbi A. O, Jani D et al. Prevalence of rheumatic heart disease detected by echocardiographic screening. N Engl J Med 2007; 357: 470-6.
[19]
Sadiq M, Islam K, Abid R, Latif F, Rehman AU, Waheed A et al. Prevalence of rheumatic heart disease in school children of urban Lahore. Heart 2009; 95 (5): 353-7.
[20]
Carapetis JP, Paar J, Cherian T. Standardization of epidemiologic protocols for surveillance of post-streptococcal sequelae: acute rheumatic fever, rheumatic heart disease and acute post-streptococcal glomerulonephritis. National Institute of Allergy and Infectious Diseases. 2006. Available from: URL: http://www.niaid.nih.gov/topics/strepThroat/Documents/groupasequelae.pdf (Cited 2014 Feb 18).
[21]
Marijon E, Celermajer DS, Tafflet M, El-Haou S, Jani DN, Ferreira B et al. Rheumatic heart disease screening by echocardiography: the inadequacy of World Health Organisation Criteria for optimizing the diagnosis of subclinical disease. Circulation 2009; 120 (8): 663-8.
[22]
Remenyi B, Wilson N, Steer A, Ferreira B, Kado J, Krishna K et al. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease - an evidenced–based guideline. Nat Rev Cardiol 2012; 9: 297-309.
[23]
Ogunbi O, Fadahunsi HO, Ahmed I, Animashaun A, Daniel SO, Onuoha DU et al. An epidemiological study of rheumatic fever and rheumatic heart disease in Lagos. J Epidemiol Community Health 1978; 32 (1): 68-71.
[24]
Atul L. Echo made easy. 3rd ed. New Delhi: Jaypee Brothers Medical Publishers; 2012. p1-63.
[25]
Meira ZM, Goulart EM, Colosimo EA, Mota CC. Long term follow up of rheumatic fever and predictors of severe rheumatic valvular disease in Brazilian children and adolescents. Heart 2005; 91 (8): 1019–22.
[26]
Abu Helwa M, Birch B. The demography and housing conditions of Palestinian refugees in and around the camps in Amman, Jordan. J Refugee Stud 1993; 6 (4): 403-13.
[27]
Saxena A, Ramakrishnan S, Roy A, Seth S, Krishnan A, Misra P et al. Prevalence and outcome of subclinical rheumatic heart disease in India: the RHEUMATIC (Rheumatic Heart Echo Utilisation and Monitoring Actuarial Trends in Indian Children) study. Heart 2011; 97 (24): 2018-22.
[28]
Steer AC, Carapetis JR, Nolan TM, Shann F. Systematic review of rheumatic heart disease prevalence in children in developing countries: the role of environmental factors. J Paediatr Child Health 2002; 38 (3): 229–34.
[29]
Shulman ST. Rheumatic heart disease in developing countries. N Engl J Med 2007; 357: 2089.
[30]
Bode-Thomas F, Okolo SN, Ekedigwe JE, Kwache IY, Adewumi O. Paediatric echocardiography in Jos University Teaching Hospital: problems, prospects and preliminary audit. Niger J Paediatr 2003; 30: 143-9.
[31]
Alkhalifa MS, Ibrahim SA, Osman SH. Pattern and severity of rheumatic valvular lesions in children in Khartoum, Sudan. East Mediterr Health J 2008; 14: 1015–21.
[32]
Carapetis JR, Hardy M, Fakakovikaetau T, Taib R, Wilkinson L, Penny DJ et al. Evaluation of a screening protocol using auscultation and portable echocardiography to detect asymptomatic rheumatic heart disease in Tongan school children. Nat Clin Pract Cardiovasc Med 2008; 5 (7): 411-7.
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