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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Prevalence of rheumatic heart disease detected by echocardiographic screening
New England Journal of Medicine, Volume 357, No. 5, Year 2007
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Description
Background: Epidemiologic studies of the prevalence of rheumatic heart disease have used clinical screening with echocardiographic confirmation of suspected cases. We hypothesized that echocardiographic screening of all surveyed children would show a significantly higher prevalence of rheumatic heart disease. Methods: Randomly selected schoolchildren from 6 through 17 years of age in Cambodia and Mozambique were screened for rheumatic heart disease according to standard clinical and echocardiographic criteria. Results: Clinical examination detected rheumatic heart disease that was confirmed by echocardiography in 8 of 3677 children in Cambodia and 5 of 2170 children in Mozambique; the corresponding prevalence rates and 95% confidence intervals (CIs) were 2.2 cases per 1000 (95% CI, 0.7 to 3.7) for Cambodia and 2.3 cases per 1000 (95% CI, 0.3 to 4.3) for Mozambique. In contrast, echocardiographic screening detected 79 cases of rheumatic heart disease in Cambodia and 66 cases in Mozambique, corresponding to prevalence rates of 21.5 cases per 1000 (95% CI, 16.8 to 26.2) and 30.4 cases per 1000 (95% CI, 23.2 to 37.6), respectively. The mitral valve was involved in the great majority of cases (87.3% in Cambodia and 98.4% in Mozambique). Conclusions: Systematic screening with echocardiography, as compared with clinical screening, reveals a much higher prevalence of rheumatic heart disease (approximately 10 times as great). Since rheumatic heart disease frequently has devastating clinical consequences and secondary prevention may be effective after accurate identification of early cases, these results have important public health implications. Copyright © 2007 Massachusetts Medical Society.
Authors & Co-Authors
Marijon, Éloi
France, Paris
Hôpital Necker Enfants Malades
France, Paris
Université Paris Cité
Mozambique, Maputo
Maputo Heart Institute
France, Paris
Hôpital Européen Georges-pompidou
Ou, Phalla
France, Paris
Hôpital Necker Enfants Malades
Cambodia, Phnom Penh
Phnom Penh University
Celermajer, David S.
Australia, Sydney
The University of Sydney
Ferreira, Beatriz
Mozambique, Maputo
Maputo Heart Institute
Mocumbi, Ana Olga H.
Mozambique, Maputo
Maputo Heart Institute
Jani, Dinesh N.
Mozambique, Maputo
Maputo Heart Institute
Paquet, Christophe
France, Saint-maurice
National Institute for Public Health Surveillance
Jacob, Sophie
France, Paris
Inserm
Sidi, Daniel
France, Paris
Hôpital Necker Enfants Malades
Jouven, Xavier P.
France, Paris
Université Paris Cité
France, Paris
Inserm
Statistics
Citations: 710
Authors: 10
Affiliations: 8
Identifiers
Doi:
10.1056/NEJMoa065085
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Maternal And Child Health
Noncommunicable Diseases
Study Design
Cross Sectional Study
Study Locations
Mozambique