Screening for rheumatic heart disease: current approaches and controversies

Kathryn Roberts, Samantha Colquhoun, Andrew Steer, Bo (Boglarka) Remenyi, Jonathan Carapetis

    Research output: Contribution to journalArticle

    Abstract

    Rheumatic heart disease (RHD) is a leading cause of cardiac disease among children in developing nations, and in indigenous populations of some industrialized countries. In endemic areas, RHD has long been a target of screening programmes that, historically, have relied on cardiac auscultation. The evolution of portable echocardiographic equipment has changed the face of screening for RHD over the past 5 years, with greatly improved sensitivity. However, concerns have been raised about the specificity of echocardiography, and the interpretation of minor abnormalities poses new challenges. The natural history of RHD in children with subclinical abnormalities detected by echocardiographic screening remains unknown, and long-term follow-up studies are needed to evaluate the significance of detecting these changes at an early stage. For a disease to be deemed suitable for screening from a public health perspective, it needs to fulfil a number of criteria. RHD meets some, but not all, of these criteria. If screening programmes are to identify additional cases of RHD, parallel improvements in the systems that deliver secondary prophylaxis are essential.
    Original languageEnglish
    Pages (from-to)49-58
    Number of pages10
    JournalNature Reviews Cardiology
    Volume10
    Issue number1
    Early online date13 Nov 2012
    DOIs
    Publication statusPublished - 2013

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  • Cite this

    Roberts, K., Colquhoun, S., Steer, A., Remenyi, B. B., & Carapetis, J. (2013). Screening for rheumatic heart disease: current approaches and controversies. Nature Reviews Cardiology, 10(1), 49-58. https://doi.org/10.1038/nrcardio.2012.157