High Prevalence of Rheumatic Heart Disease by Clinical and Echocardiographic Screening among Children in Fiji

Andrew Steer, Joseph Kado, N WILSON, T TUIKETEI, M BATZLOFF, L WAQATAKIREWA, Edward (Kim) MULHOLLAND, Jonathan Carapetis

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background and aim of the study: Rheumatic heart disease (RHD) is an important cause of morbidity and mortality in young people in developing countries. Many cases of RHD are first detected when they progress to cardiac failure. Screening for RHD represents a means of detecting cases early so that preventative measures to halt the disease progression can be put into place. Methods: A cross-sectional screening survey of RHD in 3,462 children aged 5 to 15 years in Fiji was performed in 2006. A three-stage screening method was used: stage 1 involved auscultatory screening; stage 2 was a limited echocardiography of children identified as having a suspicious murmur in stage 1; and stage 3 involved a full echocardiography of children identified as having pathology in stage 2. Results: Among the 3,462 children screened, 359 (10.4%) had a significant murmur; subsequent echocardiography was performed on 331 of these children, with RHD being detected in 29 cases. The prevalence of definite RHD was 4.1 per 1,000 (95% CI 2.2-6.8), and the overall prevalence (definite or probable RHD) was 8.4 cases per 1,000 (95% CI 5.6-12). Conclusion: The study results suggest that there is a significant burden of undetected RHD in Fiji. The three-stage approach described here represents a practical means of screening for clinical RHD in developing countries, although it does not allow detection of the subclinical disease. � Copyright by ICR Publishers 2009.
Original languageEnglish
Pages (from-to)327-335
Number of pages9
JournalJournal of Heart Valve Disease
Volume18
Issue number3
Publication statusPublished - 2009

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Fiji
Rheumatic Heart Disease
Echocardiography
Developing Countries
Disease Progression
Heart Failure
Cross-Sectional Studies
Pathology
Morbidity

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Steer, A., Kado, J., WILSON, N., TUIKETEI, T., BATZLOFF, M., WAQATAKIREWA, L., ... Carapetis, J. (2009). High Prevalence of Rheumatic Heart Disease by Clinical and Echocardiographic Screening among Children in Fiji. Journal of Heart Valve Disease, 18(3), 327-335.
Steer, Andrew ; Kado, Joseph ; WILSON, N ; TUIKETEI, T ; BATZLOFF, M ; WAQATAKIREWA, L ; MULHOLLAND, Edward (Kim) ; Carapetis, Jonathan. / High Prevalence of Rheumatic Heart Disease by Clinical and Echocardiographic Screening among Children in Fiji. In: Journal of Heart Valve Disease. 2009 ; Vol. 18, No. 3. pp. 327-335.
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abstract = "Background and aim of the study: Rheumatic heart disease (RHD) is an important cause of morbidity and mortality in young people in developing countries. Many cases of RHD are first detected when they progress to cardiac failure. Screening for RHD represents a means of detecting cases early so that preventative measures to halt the disease progression can be put into place. Methods: A cross-sectional screening survey of RHD in 3,462 children aged 5 to 15 years in Fiji was performed in 2006. A three-stage screening method was used: stage 1 involved auscultatory screening; stage 2 was a limited echocardiography of children identified as having a suspicious murmur in stage 1; and stage 3 involved a full echocardiography of children identified as having pathology in stage 2. Results: Among the 3,462 children screened, 359 (10.4{\%}) had a significant murmur; subsequent echocardiography was performed on 331 of these children, with RHD being detected in 29 cases. The prevalence of definite RHD was 4.1 per 1,000 (95{\%} CI 2.2-6.8), and the overall prevalence (definite or probable RHD) was 8.4 cases per 1,000 (95{\%} CI 5.6-12). Conclusion: The study results suggest that there is a significant burden of undetected RHD in Fiji. The three-stage approach described here represents a practical means of screening for clinical RHD in developing countries, although it does not allow detection of the subclinical disease. � Copyright by ICR Publishers 2009.",
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author = "Andrew Steer and Joseph Kado and N WILSON and T TUIKETEI and M BATZLOFF and L WAQATAKIREWA and MULHOLLAND, {Edward (Kim)} and Jonathan Carapetis",
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Steer, A, Kado, J, WILSON, N, TUIKETEI, T, BATZLOFF, M, WAQATAKIREWA, L, MULHOLLAND, EK & Carapetis, J 2009, 'High Prevalence of Rheumatic Heart Disease by Clinical and Echocardiographic Screening among Children in Fiji', Journal of Heart Valve Disease, vol. 18, no. 3, pp. 327-335.

High Prevalence of Rheumatic Heart Disease by Clinical and Echocardiographic Screening among Children in Fiji. / Steer, Andrew; Kado, Joseph; WILSON, N; TUIKETEI, T; BATZLOFF, M; WAQATAKIREWA, L; MULHOLLAND, Edward (Kim); Carapetis, Jonathan.

In: Journal of Heart Valve Disease, Vol. 18, No. 3, 2009, p. 327-335.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - High Prevalence of Rheumatic Heart Disease by Clinical and Echocardiographic Screening among Children in Fiji

AU - Steer, Andrew

AU - Kado, Joseph

AU - WILSON, N

AU - TUIKETEI, T

AU - BATZLOFF, M

AU - WAQATAKIREWA, L

AU - MULHOLLAND, Edward (Kim)

AU - Carapetis, Jonathan

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N2 - Background and aim of the study: Rheumatic heart disease (RHD) is an important cause of morbidity and mortality in young people in developing countries. Many cases of RHD are first detected when they progress to cardiac failure. Screening for RHD represents a means of detecting cases early so that preventative measures to halt the disease progression can be put into place. Methods: A cross-sectional screening survey of RHD in 3,462 children aged 5 to 15 years in Fiji was performed in 2006. A three-stage screening method was used: stage 1 involved auscultatory screening; stage 2 was a limited echocardiography of children identified as having a suspicious murmur in stage 1; and stage 3 involved a full echocardiography of children identified as having pathology in stage 2. Results: Among the 3,462 children screened, 359 (10.4%) had a significant murmur; subsequent echocardiography was performed on 331 of these children, with RHD being detected in 29 cases. The prevalence of definite RHD was 4.1 per 1,000 (95% CI 2.2-6.8), and the overall prevalence (definite or probable RHD) was 8.4 cases per 1,000 (95% CI 5.6-12). Conclusion: The study results suggest that there is a significant burden of undetected RHD in Fiji. The three-stage approach described here represents a practical means of screening for clinical RHD in developing countries, although it does not allow detection of the subclinical disease. � Copyright by ICR Publishers 2009.

AB - Background and aim of the study: Rheumatic heart disease (RHD) is an important cause of morbidity and mortality in young people in developing countries. Many cases of RHD are first detected when they progress to cardiac failure. Screening for RHD represents a means of detecting cases early so that preventative measures to halt the disease progression can be put into place. Methods: A cross-sectional screening survey of RHD in 3,462 children aged 5 to 15 years in Fiji was performed in 2006. A three-stage screening method was used: stage 1 involved auscultatory screening; stage 2 was a limited echocardiography of children identified as having a suspicious murmur in stage 1; and stage 3 involved a full echocardiography of children identified as having pathology in stage 2. Results: Among the 3,462 children screened, 359 (10.4%) had a significant murmur; subsequent echocardiography was performed on 331 of these children, with RHD being detected in 29 cases. The prevalence of definite RHD was 4.1 per 1,000 (95% CI 2.2-6.8), and the overall prevalence (definite or probable RHD) was 8.4 cases per 1,000 (95% CI 5.6-12). Conclusion: The study results suggest that there is a significant burden of undetected RHD in Fiji. The three-stage approach described here represents a practical means of screening for clinical RHD in developing countries, although it does not allow detection of the subclinical disease. � Copyright by ICR Publishers 2009.

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Steer A, Kado J, WILSON N, TUIKETEI T, BATZLOFF M, WAQATAKIREWA L et al. High Prevalence of Rheumatic Heart Disease by Clinical and Echocardiographic Screening among Children in Fiji. Journal of Heart Valve Disease. 2009;18(3):327-335.