Prevalence of rheumatic heart disease in North‐Central Nigeria: a school‐based cross‐sectional pilot study

2020 ◽  
Vol 25 (11) ◽  
pp. 1408-1415
Author(s):  
Esin Nkereuwem ◽  
Olukemi O. Ige ◽  
Christopher Yilgwan ◽  
Modou Jobe ◽  
Annette Erhart ◽  
...  
Keyword(s):  
Heart Disease ◽  
Pilot Study ◽  
Rheumatic Heart Disease ◽  
Cross Sectional ◽  
North Central ◽  
School Based ◽  
Rheumatic Heart

Prevalence of latent structural heart disease in Nepali schoolchildren

2021 ◽  
pp. 1-3
Author(s):  
Nikesh R. Shrestha ◽  
Surendra Uranw ◽  
Prahlad Karki ◽  
Santosh Bastola ◽  
Rajan Mahato ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Private Schools ◽  
Random Sampling ◽  
Structural Heart Disease ◽  
Cross Sectional ◽  
School Based ◽  
Screening Study ◽  
Cluster Random Sampling ◽  
Rheumatic Heart

Abstract Background: The present study aimed to quantify the burden of structural heart disease in Nepali children. Methods: We performed a school-based cross-sectional echocardiographic screening study with cluster random sampling among children 5–16 years of age. Results: Between December 2012 and January 2019, 6573 children (mean age 10.6 ± 2.9 years) from 41 randomly selected schools underwent echocardiographic screening. Structural heart disease was detected in 14.0 per 1000 children (95% CI 11.3–17.1) and was congenital in 3.3 per 1000 (95% CI 2.1–5.1) and rheumatic in 10.6 per 1000 (95% CI 8.3–13.4). Rates of rheumatic heart disease were higher among children attending public as compared to private schools (OR 2.8, 95% CI 1.6–5.2, p = 0.0001). Conclusion: Rheumatic heart disease accounted for three out of four cases of structural heart disease and was more common among children attending public as compared to private schools.

Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal

2020 ◽  
Vol 01 (01) ◽  
pp. 009-012
Author(s):  
Laudari S
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Rheumatic Heart

Background and Aims: Secondary prophylaxis has remained the mainstay of rheumatic fever and rheumatic heart disease management. Despite the proven ef􀏐icacy and superiority of injectable penicillin in rheumatic heart disease patients, it has been underused in Nepal. Materials and Methods: This is a hospital based cross-sectional study during June 2014 to October 2018 over a period of 52 months at College of Medical Sciences-Bharatpur including 350 patients with clinical and/or echocardiographic evidence of de􀏐inite rheumatic heart disease. Data was collected from both cardiology outpatients and inpatients (admitted in cardioward/coronary care unit). Relevant data and information were entered into the pre-structured proforma and then analyzed by SPSS-16 software. Results: The age of the patients ranged from 6 to 80 years with mean age 36.76±4.6years with female preponderance (F:M=1.26:1). The predominantly involved isolated valve was mitral in 152 patients (44.43%) followed by aortic valve in 70 patients (20.00%) and rest 90 (25.71%) had dual valvular involvement. The common complications encountered were heart failure in 200(57.14%) and arrhythmias in 155(44.29%) patients. Two hundred ten (60.00%) of the patients received penicillin (oral and injectable) and erythromycin. Majority 180/210=85.71%) were prescribed on oral penicillin whereas only 46/210=21.90% received injectable penicillin; the ratio being 3.35:1. Conclusion: RHD is a leading cause of heart failure and death among young population. There is underuse of penicillin with very minimal focus on use of injectable penicillins currently. Hence, Nepal government and other non-governmental organizations should consider implementation of use of penicillin broadly and moreover focus on use and adherence of injectable penicillin. Keywords: Rheumatic Heart Disease, Penicillin, Underuse, Secondary Prophylaxis.

scholarly journals AN EPIDEMIOLOGICAL ANALYSIS OF SOCIOECONOMIC RISK FACTORS AMONG PATIENTS OF RHEUMATIC HEART DISEASE, ISLAMABAD, PAKISTAN

1970 ◽  
Vol 6 (4) ◽  
pp. 41-43 ◽  
Author(s):  
Zafar Hayat Maken ◽  
Faizan Ahmed ◽  
Ferogh E- Elahi ◽  
Ali Arumghan ◽  
Mehar . ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Economic Status ◽  
Sampling Technique ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Male Predominance ◽  
Significant Burden ◽  
Rheumatic Heart

BACKGROUND: Rheumatic Heart Disease (RHD) is a disease of developing countries where it inflects significant burden dis-proportionality. We investigated the role of socio-economic and environmental risk factors for RHD. METHODS:· This was descriptive cross-sectional conducted at Pakistan Institute of Medical Sciences Islamabad by including the patients coming to cardiology out door patient department through convenient sampling technique. Study was approved from ethical committee of Pakistan institute of Medical Sciences Islamabad and written consent was taken prior to start the interview. RESULTS: In this study, the average age of patient with rheumatic heart disease was 29.4 years, male predominance of patients was observed. 67% of subjects had income below Rs. 20,000. Average BMI of subjects was 22.4±4.04. It was observed that 75.25 % of people lived in houses with an area of less than 5 marla. Average area of house was found to be 5.12±2.8 marla. Overcrowding was noticed in 60.8 % of the subjects. CONCLUSION: There is a high prevalence of RHD and Acute Rheumatic Fever (ARF) in Pakistan. The major findings of this study were that Overcrowding, poor hygienic conditions, low socio-economic status, are major risk factors for RHD. In order to address this alarming situation, platforms like Pakistan Pediatric Cardiac Society and Pakistan Pediatric Association need to be mobilized for health promotion regarding awareness of the disease.

scholarly journals Fetomaternal Outcome in Pregnancy With Cardiac Disease

2012 ◽  
Vol 23 (1) ◽  
pp. 31-35
Author(s):  
Shahanaj Sharmin ◽  
Shahanara Chowdhury ◽  
Didarul Alam ◽  
Mohiuddin Ahmed ◽  
Fahamida Rashid ◽  
...  
Keyword(s):  
Heart Disease ◽  
Birth Weight ◽  
Pregnant Women ◽  
Rheumatic Heart Disease ◽  
Cardiac Disease ◽  
Cross Sectional Study ◽  
Normal Vaginal Delivery ◽  
College Hospital ◽  
Cross Sectional ◽  
Rheumatic Heart

Aim of our study was to see the maternal and fetal outcomes in women presenting with heart disease during pregnancy and labout. This cross sectional study was carried out in 48 pregnant women with cardiac disease from July 2005 to Dec 2006, in the department of Gynae and Obst at Chittagong Medical College Hospital Chittagong. The Mewan age was 25.40 ±4.46 years. 31(64.6%) patients were from middle class. 27 (56.3%) patients belonged to mulliparous group. 33(68.8%) patients received regular antenatal care, of the 43 (89.7%) patients had rheumatic heart disease and 5(10.5%) had congenital heart disease. Among the rheumatic heart disease, 50% had mitral stenosis. 35(72.9%) patients had in grade-1, 12(25%) had in grade-II, and 1(2.1%) had in grade-III. (64.5%) had normal vaginal delivery, 7(14.5%) had LSCS. 4(8.3%) had heard failure and 1 patient (2.1%) expired due to heart failure, 40(83.3%) were delivered at term, 7(14.6%) had preterm labour and 1(2.1%) had still birth. Regarding birth weight, 17(35.4%) had LBW (Low birth weight), 31(64.6%) had normal birth weight. Rheumatic heart disease is the commonest cardiac lesion among Pregnant women. Fetomaternal morbidity and mortality are strongly correlated with maternal cardiac functional classification. The management of these cases should be multidisciplinary to optimize care of these patients. JCMCTA 2012; 23(1): 31-35

scholarly journals Throat colonization and antibiotic susceptibility of group A β-hemolytic streptococci among rheumatic heart disease patients attending a cardiac referral hospital in Tanzania, A descriptive cross-sectional study

2019 ◽  
Author(s):  
Sarah Wangilisasi ◽  
Pilly Chillo ◽  
Delila Kimambo ◽  
Mohammed Janabi ◽  
Appolinary Kamuhabwa
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Antibiotic Susceptibility ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Group A ◽  
Rheumatic Heart

Abstract Background: Secondary prophylaxis against repeated attacks of acute rheumatic fever is an important intervention in patients with rheumatic heart disease (RHD) and it aims to prevent throat infection by group A beta-hemolytic streptococcus (GAS), however its implementation faces many challenges. This study aimed to assess throat colonization, antibiotic susceptibility and factors associated with GAS colonization among patients with RHD attending care at Jakaya Kikwete Cardiac Institute in Dar-es-Salaam, Tanzania. Methods: A descriptive cross sectional study of RHD patients attending the Jakaya Kikwete Cardiac Institute was conducted from March to May 2018, where we consecutively enrolled all patients known to have RHD and coming for their regular clinic follow-up. A structured questionnaire was used to obtain patients’ socio-demographic information, factors associated with GAS colonization as well as status of secondary prophylaxis use and adherence. Throat swabs were taken and cultured to determine the presence of GAS, and isolates of GAS were tested for antibiotic susceptibility using Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) version 2015. Antibiotics of interest were chosen according to the Tanzanian Treatment Guidelines. Results: In total 194 patients with RHD were enrolled, their mean age was 28.4 ±16.5 years and 58.2% were females. Only 58 (29.9%) patients were on regular prophylaxis, 39 (20.1%) had stopped taking prophylaxis, while 97 (50.0%) had never been on prophylaxis. Throat cultures were positive for GAS in 25 (12.9%) patients. Patients who stopped prophylaxis were 3.26 times more likely to be colonized by GAS when compared to patients on regular prophylaxis. Majority (96%) of GAS isolates were susceptible to Penicillin, Ceftriaxone and Ciprofloxacin, while the highest resistance (20%) was observed with Vancomycin. No GAS resistance was observed against Penicillin. Conclusion: The prevalence of GAS throat colonization is high among this population and is associated with stopping prophylaxis. The proportion of patients on regular secondary prophylaxis is unacceptably low and interventions should target both patients’ and physicians’ barriers to effective secondary prophylaxis.

scholarly journals RHEUMATIC HEART DISEASE (RHD)

2016 ◽  
Vol 23 (03) ◽  
pp. 324-327
Author(s):  
Ahsan Beg Beg ◽  
Muhammad Younas ◽  
Touseef Asma
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Rural Areas ◽  
Urban Areas ◽  
Economic Status ◽  
Cross Sectional ◽  
Rural And Urban ◽  
Cardiology Department ◽  
Urban And Rural Areas ◽  
Rheumatic Heart

Objectives: To investigate the role of socio-economic factors for Acute RheumaticFever (ARF) and Rheumatic Heart Disease (RHD) in Pakistan. Methodology: Study Design:Descriptive cross-sectional. Setting: OPD of Pediatric Cardiology Department, CPE Institute ofCardiology, Multan. Period: July 2014 to December 2014. Convenience Sampling was done.Sample size of 130 cases with ages between 5 to 12 years were selected for the study. Results:Overcrowding was noticed in 61% and 85% in urban and rural areas, respectively. In rural areas,most parents were illiterate; similar status was seen in urban areas (64.4%; 67.1% respectively).60% and 55 % patients have habit of hand washing in rural and urban patients respectively.Toilet facility is available to 60% and 55.6% in rural and urban patients respectively. Economicstatus of the family is even worse. Average income per family was only Rs.3800 per month.Conclusion: There is a high prevalence of Rheumatic heart disease (RHD) and acute rheumaticfever (ARF) in Pakistan. Overcrowding, poor hygienic conditions, low socio-economic status,illiteracy are major risk factors for ARF and RHD in Pakistan. In order to address this alarmingsituation, platforms like Pakistan Pediatric Cardiac Society and Pakistan Pediatric Associationneed to be mobilized.

Abstract 18513: School-based Rheumatic Heart Disease Education Results in Improved Knowledge - Data From the PROVAR Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Bruno R Nascimento ◽  
Andrea Z Beaton ◽  
Graziela Chequer ◽  
Kaciane K Bruno ◽  
Cassio O Miri ◽  
...  
Keyword(s):  
Heart Disease ◽  
Knowledge Transfer ◽  
Rheumatic Heart Disease ◽  
Low Income ◽  
Public Awareness ◽  
Median Score ◽  
Educational Curriculum ◽  
School Based ◽  
Post Test ◽  
Rheumatic Heart

Introduction: Rheumatic Heart Disease (RHD) remains an important cause of morbidity and mortality in Brazil and other low- and middle-income countries (LMIC). Lack of public awareness of the causes and prevention of RHD limit the efficacy of primary and secondary prevention programs. Objectives: To evaluate the efficacy of knowledge transfer that results from a structured public-school educational program on RHD. Methods: A prospective, cohort study was conducted over 7 months (9/2014-3/2015) in 5 randomly selected low-income public schools in Belo Horizonte, Brazil. All enrolled and present students received education. A nurse and an imaging technician utilized two custom structured educational curriculums, targeting children in grades 6 - 11 (aged 11-17). Pre-tests, taken immediately prior to educational curriculum queried students’ knowledge of the causes, prevention, diagnosis, and treatment of RHD. Post-tests, 1-3 weeks following education assessed the efficacy of knowledge transfer and retention. Results: The educational curriculum was delivered to 3200 students. One-third of these (1025) were randomly selected to participate in pre- and post-testing including 403 (39%) in 6th/7th grades (G1), 360 (35%) in 8th/9th (G2), and 261 (26%) of in 10th/11th grades (G3). The mean interval between pre-test and post-test was 10±10 days. Prior to the intervention, general knowledge regarding RHD was universally low (median score 46.7%, 40.0-60.0). Children in higher grades (G3) knew more about RHD than those in lower grades (60% vs. 40.0% G1/46.7% G2), p<0.001. Children showed significant gains in the post-test, raising the median score by 20 percent (60%, 40.0-73.3). Again, children in the higher grades showed higher overall scores (73%, 60.0-80.0 G3; 56.7%, 40.0-73.3 G2; 53.3%, 33.3-66.7 G1), p<0.001. However, the percent increase was similar between groups (6.8% G1, 6.8% G2, 8.5% G3), p=0.47. Conclusions: School-based RHD education resulted in consistent but modest gains in knowledge. Novel educational techniques and use of technology to engage young learners may lead to improved knowledge gains and retention. Further studies are needed to determine if increased knowledge leads to behavioral changes that could decrease the burden of RHD in LMIC.

scholarly journals Clinical Characteristics and Number of Valve Lesion in Rheumatic Heart Disease Severity

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Saskia Ratna Desita ◽  
Achmad Lefi ◽  
Mahrus Rahman ◽  
Yudi Her Oktaviono
Keyword(s):  
Socioeconomic Status ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Disease Severity ◽  
Low Socioeconomic Status ◽  
Clinical Characteristics ◽  
Cross Sectional ◽  
Low Socioeconomic ◽  
Valve Lesion ◽  
Rheumatic Heart

Rheumatic heart disease (RHD) occurs due to sequelae in the form of damage to the heart valves from the failure of acute rheumatic fever (ARF) therapy. Heart valve damage can cause various complications such as congestive heart failure, arrhythmias, pulmonary hypertension, atrial fibrillation, endocarditis, which can cause death. The study aimed to assess the association between clinical characteristics and valve lesion and rheumatic heart disease severity. The study was an analytic observational with a cross-sectional design of 73 patients with definite RHD from September 2019 to March 2020 in Dr. Soetomo Regional General Hospital. The majority of patients were female (80%, p=0.235) 30–39 years old (34%, p=0.157). The mean age was 42.08±12.16 years. The majority of patients have low socioeconomic status (78%, p=0.025) and rural dwelling location (70%, p=0.138) over three-quarters of patients living with more than four people in the same house (75%). Multivalvular lesions (90%, p=0.003) and severe RHD (77%) were present predominantly. In conclusion, low socioeconomic status and multivalvular lesions are associated with rheumatic heart disease severity. KARAKTERISTIK KLINIS DAN JUMLAH LESI KATUP PADA DERAJAT KEPARAHAN PENYAKIT JANTUNG REUMATIKPenyakit jantung reumatik (PJR) adalah penyakit yang terjadi akibat gejala sisa berupa kerusakan katup jantung dari kegagalan terapi demam reumatik akut (DRA). Kerusakan katup jantung pada PJR dapat menimbulkan berbagai komplikasi seperti gagal jantung kongesti, aritmia, hipertensi pulmonal, atrial fibrilasi, dan endokarditis yang dapat menyebabkan kematian. Penelitian ini bertujuan mencari hubungan karakteristik klinis dan jumlah lesi katup dengan derajat keparahan PJR. Penelitian ini merupakan analitik observasional menggunakan pendekatan cross-sectional. Sampel penelitian ini adalah pasien yang terdiagnosis definitif PJR berdasar atas ekokardiografi pada bulan Sepetember 2019–Maret 2020 di RSUD Dr. Soetomo Surabaya. Didapatkan 73 pasien sesuai dengan kriteria inklusi. Mayoritas pasien berjenis kelamin perempuan (80%; p=0,235), dengan kelompok usia 30–39  (34%; p=0,157). Usia rerata 42,08±12,16 tahun. Sebagian besar pasien berstatus sosial ekonomi rendah (78%, p=0,025) dan lokasi tinggal pedesaan (70%; p=0,138). Lebih dari tiga perempat pasien tinggal dengan ≤4 orang di satu atap (75%). Lesi multivalvular (90%; p=0,003) dan PJR berat (77%) ditemukan secara dominan. Simpulan, status sosial ekonomi rendah dan lesi katup multivalvular berhubungan dengan derajat keparahan penyakit jantung reumatik.

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