Authors:
Colquhoun SM, Kado JH, Remenyi B, Wilson NJ, Carapetis JR, Steer AC
Authors notes:
International Journal of Cardiology 173(2): 284-289
Keywords:
Developing country, Echocardiography, Epidemiology, Fiji, Prevalence, Rheumatic heart disease
Abstract:
Aim of the study is to estimate the echocardiography confirmed prevalence of rheumatic heart disease (RHD) in school children in Fiji.
Cross-sectional observational study across ten primary schools in Fiji in school children aged 5-14 years.
Each child had an echocardiogram performed by an echocardiographic technician subsequently read by a paediatric cardiologist not involved with field screening, and auscultation performed by a paediatrician.
Echocardiographic criteria for RHD diagnosis were based on those previously published by the National Institutes of Health (NIH) and World Health Organization (WHO), and data were also analyzed using the new World Heart Federation (WHF) criteria.
Using the modified NIH/WHO criteria the prevalence of definite RHD prevalence was 7.2 cases per 1000, and the prevalence of probable RHD 28.2 cases per 1000.
By applying the WHF criteria the prevalence of definite and borderline RHD was 8.4 cases per 1000 and 10.8 cases per 1000 respectively.
Definite RHD was more common in females and in children who attended school in a rural location.
Auscultation was poorly sensitive compared to echocardiography (30%) in the detection of asymptomatic RHD.
There is a high burden of undiagnosed RHD in Fiji.
The results of this study highlight the importance of the use of highly sensitive and specific diagnostic criteria for echocardiography diagnosis of RHD.