Focused cardiac ultrasound screening for rheumatic heart disease by briefly trained health workers: a study of diagnostic accuracy

Abstract

Cure Kids, New Zealand; the Fiji Water Foundation provided funding for portable ultrasound equipment; see acknowledgments for further details of funders.

Screening-detected rheumatic heart disease can progress to severe disease

“…Fiji has a very high burden of RHD, with a prevalence of definite RHD of 7–8 per 1000 on echocardiographic screening of school-aged children 14 15. RHD is one of the leading causes of mortality in children and young adults 16.…”

“…All young people with any form of RHD diagnosed on echocardiography (ie, ‘probable’ or ‘definite’ RHD using criteria from the National Institutes for Health and WHO (NIH-WHO),18 or ‘borderline’ or ‘definite’ RHD using WHF criteria) during previous screening studies in Fiji from 2006 to 201314 15 19 20 were eligible to participate. Research staff contacted eligible families with an invitation to participate and provided verbal and written information regarding study procedures.…”

Adherence to secondary antibiotic prophylaxis for patients with rheumatic heart disease diagnosed through screening in Fiji

“…Echocardiographic screening for RHD has been conducted in Fiji since 2006. Four previous research projects have investigated approaches to screening using echocardiography, as described elsewhere . In addition, the Ministry of Health coordinated 14 outreach screening activities over the period 2008–2014, mainly to remote communities.…”

Echocardiography in Indigenous Populations and Resource Poor Settings

“…Though in early stages, research in task-shifting of echocardiography in low-resource settings shows promise. In Fiji, nurses utilising basic portable echocardiographic equipment were able to detect RHD with a sensitivity of 84% and specificity of 85% [53]. Similar results were replicated in New Caledonia [54] and Uganda [55].…”