PREVALENCE OF ACUTE RHEUMATIC FEVER (ARF) & RHEUMATIC HEART DISEASE (RHD) IN URBAN SCHOOL CHILDREN OF DISTRICT SRINAGAR

Abstract

Rheumatic Heart Disease (RHD) is still a major public health problem in developing countries such as India. Present study was conducted in urban population of district Srinagar of J&K state (India). A study had been conducted in the same population in 1983 & the prevalence at that time was 5.9 / 1000. The aim of the present study was to know the present status of Acute Rheumatic Fever (ARF) & RHD in the same population since we have observed a significant decline in the attendance of these patients in OPD & wards of Sheri-Kashmir Institute of Medical Sciences (SKIMS) Srinagar. A survey of school children aged between 6-16 years studying in randomly selected private and government schools of Srinagar-city was done. A total of 5661 school children were examined. Eleven school children were found to have heart disease. Of these 4 had RHD, confirmed on Echocardiography while 7 had congenital heart disease (CHD) and were excluded from the study. No case of ARF could be identified. As per our study the prevalence of RHD is 0.7/1000 school children. The results observed were lower than that reported in earlier studies from developing countries, but are comparable to large studies conducted in Christian Medical College Vellore in 2003 & Gorakhpur in 2005-2006. Therefore it is concluded that there has been a dramatic decline in prevalence of RHD over last two decades.

School-based surveillance for detection of children with acute pharyngitis, rheumatic fever/rheumatic heart disease in Shimla district, Himachal Pradesh, India—A cluster randomized controlled trial

“…The survey studies reported from different urban and rural areas in India using auscultation based screening and echocardiography confirmation in suspected cases by different investigators suggests declining trends especially in last decade or so 15, 16, 17, 18,21. The two-point survey study done by our group among school children of Shimla city and adjoining rural area in year 1992-93 and in year 2006–07 using same screening method demonstrated about five fold decline in the prevalence (2.89/1000 to 0.89/1000) 21…”

“…The number of children with RF/RHD detected in present school-based surveillance system is significantly lower than the figures reported from active surveillance studies in school children. 15, 16, 17, 18, 19 In a survey study of school children aged 5–15 years in government schools of Shimla district in 2007–08 under Gian Vigyan Mission mode project prevalence of RF/RHD was 1.0/1000 (unpublished data).…”