Echocardiographic prevalence of rheumatic heart disease in Brazilian schoolchildren: Data from the PROVAR study
| Autor: | Iara M. Castro, Andrea Beaton, Antonio Luiz Pinho Ribeiro, Kaciane K.B. Oliveira, Vitória M.L.R. Rezende, Sandra Regina Tolentino Castilho, Zilda Maria Alves Meira, Bruno Ramos Nascimento, Allison R. Tompsett, Cassio M. Oliveira, Graziela Chequer, Eduardo L Lopes, Craig Sable, Maria do Carmo Pereira Nunes, Gabriel Assis Lopes do Carmo, Adriana C. Diamantino, Taylor Landay |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Heart disease Adolescent Cross-sectional study Early detection Disease 030204 cardiovascular system & hematology Social class Vulnerable Populations 03 medical and health sciences 0302 clinical medicine medicine Prevalence Humans 030212 general & internal medicine Prospective Studies Prospective cohort study Child Students Mitral regurgitation business.industry Public health Rheumatic Heart Disease medicine.disease Telemedicine Cross-Sectional Studies Social Class Echocardiography Child Preschool Female Cardiology and Cardiovascular Medicine business Brazil |
| Zdroj: | International journal of cardiology. 219 |
| ISSN: | 1874-1754 |
| Popis: | Accurate estimates of Rheumatic Heart Disease (RHD) burden are needed to justify improved integration of RHD prevention and screening into the public health systems, but data from Latin America are still sparse.To determine the prevalence of RHD among socioeconomically disadvantaged youth (5-18years) in Brazil and examine risk factors for the disease.The PROVAR program utilizes non-expert screeners, telemedicine, and handheld and standard portable echocardiography to conduct echocardiographic screening in socioeconomically disadvantaged schools in Minas Gerais, Brazil. Cardiologists in the US and Brazil provide expert interpretation according to the 2012 World Heart Federation Guidelines. Here we report prevalence data from the first 14months of screening, and examine risk factors for RHD.5996 students were screened across 21 schools. Median age was 11.9 [9.0/15.0] years, 59% females. RHD prevalence was 42/1000 (n=251): 37/1000 borderline (n=221) and 5/1000 definite (n=30). Pathologic mitral regurgitation was observed in 203 (80.9%), pathologic aortic regurgitation in 38 (15.1%), and mixed mitral/aortic valve disease in 10 (4.0%) children. Older children had higher prevalence (50/1000 vs. 28/1000, p0.001), but no difference was observed between northern (lower resourced) and central areas (34/1000 vs. 44/1000, p=0.31). Females had higher prevalence (48/1000 vs. 35/1000, p=0.016). Age (OR=1.15, 95% CI:1.10-1.21, p0.001) was the only variable independently associated with RHD findings.RHD continues to be an important and under recognized condition among socioeconomically disadvantaged Brazilian schoolchildren. Our data adds to the compelling case for renewed investment in RHD prevention and early detection in Latin America. |
| Databáze: | OpenAIRE |
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