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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Leveraging School Health Programs in Africa: Integrated Screening for Rheumatic Heart Disease and Dental Caries
Annals of Global Health, Volume 89, No. 1, Article 81, Year 2023
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Description
Background: Rheumatic heart disease (RHD) and dental caries (DC) disproportionately affect children and young adults in sub-Saharan countries, with major impact on schoolchildren’s health and education. DC in children with RHD constitutes an important risk for fatal complications. Our study aimed at assessing the feasibility of simultaneous RHD and DC screening in school environment. Methods: March 20–24, 2022, we performed an observational descriptive study of schoolchildren in a public school in Maputo City, Mozambique. RHD screening involved two stages: first, a physical examination (including cardiac auscultation and direct observation of the oral cavity), and second, an abbreviated echocardiography performed by a cardiologist. Rapid testing for group A Streptococcus (GAS) was done to every eighth child in the classroom and for those with signs suggesting recent infection, in accordance with the study protocol developed for screening. A multidisciplinary team collected the data. Data were analyzed using descriptive statistics. Findings: A total of 954 students (median age 9; range 6–15) were screened. One hundred and twenty-five participants were eligible for a rapid antigen test, of which 6 (4.8%) tested positive. On clinical evaluation 52 children (5.3%) presented a heart murmur. Echocardiography on 362 children showed borderline RHD in 35 children and definite RHD in 2 (0.6%); 1 child had a ventricular septal defect. Dental cavities were present in 444 (48.4%), despite 904 out of 917 students reporting brushing of their teeth once to three times daily (98.6%). Conclusion: School-based integrated oral and cardiovascular screenings and use of rapid tests for GAS carriage provide crucial information to create customized preventive strategies for rheumatic fever (RF) and RHD in low-and middle-income countries (LMICs), in addition to detecting children at very high risk of bacterial endocarditis. The sustainability of such interventions and acceptability by health providers needs to be assessed. © 2023 The Author(s).
Authors & Co-Authors
Amade, Euridsse Sulemane
Mozambique, Beira
Instituto Nacional de Saúde Ins
Lichucha, Edna
Mozambique, Beira
Instituto Nacional de Saúde Ins
Jamal, Keila K.F.
Unknown Affiliation
Mastala, Adjine
Mozambique, Beira
Instituto Nacional de Saúde Ins
Soares, Carlos José Osé
Brazil, Uberlandia
Universidade Federal de Uberlândia
Mocumbi, Ana Olga H.
Mozambique, Maputo
Universidade Eduardo Mondlane
Mozambique, Marracuene
Instituto Nacional de Saúde
Statistics
Authors: 6
Affiliations: 6
Identifiers
Doi:
10.5334/aogh.4239
ISSN:
22149996
Research Areas
Health System And Policy
Maternal And Child Health
Noncommunicable Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Mozambique