Rheumatic Heart Disease In Eritrean Schoolchildren: Results From An International Cooperation Project

Background Rheumatic Heart Disease is one of the main non-communicable diseases in low-to-middle income countries and represents the second leading cause of cardiovascular morbidity and mortality in endemic areas. To date, no cross-sectional surveys have been conducted in Eritrea. The aim of this study is to determine the prevalence of rheumatic heart disease in eritrean schoolchildren. Methods Randomly selected schoolchildren from 4 to 19 years of age in Eritrea were screened for rheumatic heart disease according to standard echo-cardiographic criteria. Results Echocardiographic screening detected rheumatic heart disease in 390 of 8945 schoolchildren. The overall prevalence of rheumatic heart disease was 43.6 cases per 1000 (95% CI, 39.4 to 47.8). The prevalence was higher in rural areas compared to urban areas (odds ratio 2.2; 95% CI, 2.8 to 1.7; p < 0.0001) and increased with age (chi-squared for trend 12.44; p = 0.0004). The mitral valve and aortic valve were involved in the 97% and 11,3% of cases, respectively. Congenital heart disease was detected in 103 children and the prevalence was 11.5 cases per 1000 (95% CI, 13.7 to 9.3). Conclusions Echocardiographic screening revelead for the first time the prevalence of rheumatic heart disease in eritrean schoolchildren. The prevalence was one of the highest in the world. These results may have important public health implications and may represent a first step for the implementation of a national prevention program