134 Prevalence of rheumatic heart disease in SENEGAL. An echocardiographic screening

BackgroundMost of the epidemiological studies of the prevalence of rheumatic heart disease have used clinical screening with echocardiographic confirmation of suspected cases.A recent study with systematic echographic screening of all surveyed children shows a higher prevalence of rheumatic heart disease in Cambodgia and Mozambique (10 times grater than what was found by clinical screening alone).We conducted this study to estimate the prevalence of rheumatic heart disease in school-age children of Senegal, a sub-saharan African country.MethodsRandomly selected school children from 5 to 18 years of age in Dakar, the capital city of Senegal, were screened for rheumatic heart disease according to standard clinical and echocardiographic criteria. The echocardiographic examination was performed with a Sonosite Micromax Machine using M-Mode, 2D, Color flow, pulse Doppler and continous Doppler.ResultsThe total population was 2004 children. 51.6% were male. The mean age was 14 years.Clinical examination detected rheumatic heart disease that was confirmed by echocardiography in 3 children.The echocardiographic screening detected 15 cases of rheumatic heart diseases. The prevalence rates was 1.5 cases per 1000 using clinical criteria and 7.5 cases per 1000 if echocardiographic screening was used. Males were more affected than girls. The mitral valve was involved alone in 53.3% of cases. Mitral and aortic valves were both involved in 40% of cases. The aortic valve was involved alone in 6.7% of cases.ConclusionOur studies confirmed that echocardiographic screening, as compared with clinical screening, is more accurate and showed a higher prevalence of rheumatic heart disease. However, the prevalence rate in Senegal is lower than that found in Mozambique and Cambodgia, using the same criteria