PT438 Profile Of Rheumatic Heart Disease At A Cardiac Center In Bandung City, Indonesia: An Echocardiography Study

BackgroundRheumatic heart disease (RHD) remains a significant cause of cardiovascular morbidity and mortality in developing countries such as Indonesia. Yet, despite being one of the most readily preventable chronic diseases, RHD has received scant research or policy attention, particularly in South-East Asia.AimTo describe the pattern of RHD occurrence in a sample of presenting cases from an occupational cohort in Papua Province, Indonesia.MethodsClinical records of 15 608 mining workers (96.4% men, mean age 36.3±7.4 years) were reviewed retrospectively to identify and extract data on all rheumatic fever (RF) and RHD cases admitted to two hospitals in Papua during 2008–2013. Collected data included basic demographics, employment history and echocardiographic findings.Results83 RHD cases (95.6% men, mean age 39.6±12.5 years) and 3 RF cases were identified between 2008 and 2013. Increased RHD risk was observed among those aged 35–44 (HR=3.60) and 45–68 (HR=4.46) years relative to the youngest age group (p<0.01). RHD incidence density was 6.84 per 10 000 person years of follow-up. Among cases, mitral stenosis was the most common valvular lesion at initial presentation (41.0%), and 6.0% were multivalvular.ConclusionsThe prevalence of RHD in Papuan mining workers correlates with adult prevalence data in other populations with a high RHD burden, highlighting RHD as a significant health issue into adulthood. The late stage at which most patients presented points to a strong need for earlier intervention. Both primary and secondary preventive measures must be considered critical tools to prevent and reduce RHD burden, particularly among older age groups.

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“…In West Java, 108 patients aged 17–75 years were identified with RHD, with complications suggesting an advanced burden of the disease. 11 …”

Section: Introductionmentioning

confidence: 99%

Rheumatic heart disease among adults in a mining community of Papua, Indonesia: findings from an occupational cohort

Rodríguez-Fernández¹,

Amiya

Wyber

et al. 2015

Heart Asia

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“…In Bandung, the prevalence was quite high, presumably because the study was performed in a cardiac referral center with cardiac patients as the population. The different results from small studies in Indonesia urge the need to perform screening in the general population to determine the real prevalence in Indonesia ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…From the worldwide epidemiology data of acute rheumatic disease and RHD, the only data available from Indonesia reported that the prevalence of RHD was <1% from 1970 through 1990 (18). However, some recent studies reported local prevalence of RHD in some parts of Indonesia (19)(20)(21).…”

Section: The Problem Of Rhd In Indonesiamentioning

confidence: 99%

“…An echocardiography study from a cardiac center in Bandung, West Java, Indonesia, found that during 13 months of observation, a total of 108/4,682 (2.3%) of patients showed echocardiography morphology of RHD, with a mean age of 44 years (17-75) and predominantly female (78%). A combination of MV and AV involvement was the most common echo findings (56.48%), followed by a mixed MV disease in 25.92%, whereas isolated mitral stenosis was found in 17.6% patients (20). Just recently, Suastika et al conducted a local RHD screening in one remote area in Bali (21).…”

Section: The Problem Of Rhd In Indonesiamentioning

confidence: 99%

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Echocardiography Screening for Latent Rheumatic Heart Disease: What Can We Do in Indonesia?

Soesanto

Suastika

2020

Front. Surg.

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Rheumatic heart disease (RHD), a sequela of acute rheumatic fever (ARF), is a preventable disease but remains a significant health problem, especially in developing countries. It causes disability, poor quality of life, early mortality, and national economic burden. The World Heart Federation (WHF) aimed to achieve a 25% reduction in premature deaths from ARF and RHD among individuals aged <25 years by 2025. Primordial and primary prophylaxis of RHD is aimed to prevent the occurrence of ARF, while the goal of secondary and tertiary prophylaxis is to limit the progression and reduce the consequences of RHD. Early recognition of RHD is important for early prophylaxis strategies to inhibit any progression to advanced stages. In 2012, WHF introduced the latest echocardiographic criteria to recognize the early stage of RHD. This includes the evaluation of pathological regurgitation jet and morphological features of RHD based on 2D, color, and spectral Doppler criteria. In remote areas, portable echocardiography is preferable for RHD screening. Previous portable devices were only capable of producing 2D and color images. Hence, a simplified echocardiographic criterion without spectral Doppler evaluation is needed in selected areas. Indonesia is a developing country, an archipelago with a population of over 250 million. Currently, there are no data on ARF incidence and RHD prevalence nationwide. The only data available are the number of patients in advanced stages who came to referral centers for further management. The screening program has to be introduced in Indonesia as part of national RHD prophylaxis.

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PT438 Profile Of Rheumatic Heart Disease At A Cardiac Center In Bandung City, Indonesia: An Echocardiography Study

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Rheumatic heart disease among adults in a mining community of Papua, Indonesia: findings from an occupational cohort

Rheumatic heart disease among adults in a mining community of Papua, Indonesia: findings from an occupational cohort

Echocardiography Screening for Latent Rheumatic Heart Disease: What Can We Do in Indonesia?

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