Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-24T09:11:53.629Z Has data issue: false hasContentIssue false

Prevalence of latent structural heart disease in Nepali schoolchildren

Published online by Cambridge University Press:  04 November 2021

Nikesh R. Shrestha
Affiliation:
Department of Cardiology, Neuro Cardio and Multispeciality Hospital, Biratnagar, Nepal
Surendra Uranw
Affiliation:
Department of Internal Medicine and Cardiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
Prahlad Karki
Affiliation:
Department of Internal Medicine and Cardiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
Santosh Bastola
Affiliation:
Department of Internal Medicine and Cardiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
Rajan Mahato
Affiliation:
Department of Internal Medicine and Cardiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
Kunjang Sherpa
Affiliation:
Department of Internal Medicine and Cardiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
Sahadeb Dhungana
Affiliation:
Department of Cardiology, Noble Medical College Teaching Hospital and Research Center, Biratnagar, Nepal
Keshar Gurung
Affiliation:
Department of Cardiology, Neuro Cardio and Multispeciality Hospital, Biratnagar, Nepal
Naveen Pandey
Affiliation:
Department of Internal Medicine and Cardiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
Krishna Agrawal
Affiliation:
Department of Internal Medicine and Cardiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
Joanna Bartkowiak
Affiliation:
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Prashant Shah
Affiliation:
Department of Internal Medicine and Cardiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
Martina Rothenbühler
Affiliation:
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Thomas Pilgrim*
Affiliation:
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
*
Author for correspondence: T. Pilgrim, MD, MSc, Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Bern CH-3010, Switzerland. Tel: +0041 31 632 21 11; Fax: +0041 31 632 47 70. E-mail: thomas.pilgrim@insel.ch

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.

Type
Brief Report
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rothenbühler, M, O’Sullivan, CJ, Stortecky, S, et al. Active surveillance for rheumatic heart disease in endemic regions: a systematic review and meta-analysis of prevalence among children and adolescents. Lancet Glob Health 2014; 2: e717e726.CrossRefGoogle ScholarPubMed
Pilgrim, T, Kalesan, B, Karki, P, et al. Protocol for a population-based study of rheumatic heart disease prevalence and cardiovascular outcomes among schoolchildren in Nepal. BMJ Open 2012; 2: e001320.CrossRefGoogle ScholarPubMed
Karki, P, Uranw, S, Bastola, S, et al. Effectiveness of systematic echocardiographic screening for rheumatic heart disease in Nepalese schoolchildren: a cluster randomized clinical trial. JAMA Cardiol 2021; 6: 420426.CrossRefGoogle ScholarPubMed
Shrestha, NR, Karki, P, Mahto, R, et al. Prevalence of subclinical rheumatic heart disease in Eastern Nepal: a school-based cross-sectional study. JAMA Cardiol 2016; 1: 8996.CrossRefGoogle Scholar
Reményi, B, Wilson, N, Steer, A, et al. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease-an evidence-based guideline. Nat Rev Cardiol 2012; 9: 297309.CrossRefGoogle ScholarPubMed
Shrestha, NR, Bruelisauer, D, Uranw, S, et al. Mid-term outcome of children with latent rheumatic heart disease in Eastern Nepal. Open Heart 2021; 8: e001605.CrossRefGoogle ScholarPubMed
Ministry of Education, United Nations Children’s Fund (UNICEF) and United Nations Educational, Scientific and Cultural Organization (UNESCO). Global Initiative on Out-of-School Children – Nepal Country Study. UNICEF, Kathmandu, Nepal, 2016.Google Scholar