Rheumatic Heart Disease in school going children: A cross-sectional epidemiological profile of Jajarkot, Nepal

Abstract

Background and Aims: Rheumatic Heart Disease (RHD) is the most common heart disease among children and young adults in Nepal. Identifying the prevalence of RHD is important in planning RHD prevention program. There are few studies on RHD conducted among children of unreached population of Nepal. This study aimed to determine the epidemiological status of RHD among school going children living in rural and underdeveloped community of Jajarkot, Nepal.
 Methods: This is a cross-sectional study of 6,147 school going children of age group 5 to 16 years from 24 randomly selected schools of Jajarkot in the month of May, 2018. A team of cardiologists from Nepal Heart Foundation examined the children. Diagnosis of RHD was confirmed by echocardiography. Selected socio-demographic data were collected. All positive cases were reviewed by senior cardiologist. Information obtained were analyzed. Frequency and percentage for the categorical data were calculated. Prevalence was reported as cases per thousand school children.
 Results: The overall prevalence of RHD was 7.32 per 1000 schoolchildren. Borderline RHD was 1.30 per 1000 and definite RHD 6.02 per 1000. On severity scale, mild RHD was 6.18, moderate RHD 0.81 and severe RHD 0.33 per 1000 respectively. Prevalence of RHD varied with age, sex, ethnicity, and severity. RHD was found higher among males, 10-16 years age group and underprivileged children.
 Conclusion: Jajarkot is found to be a RHD endemic zone in Nepal where prevention efforts should be initiated urgently.

Rheumatic heart disease in school-attending Nepalese children: A descriptive analysis of the national heart screening database

“… 14 A similar study conducted in Jajarkot, Nepal, documented an overall prevalence of RHD of 7.32 per thousand school children. 15 Another study carried out among 26 schools in the Sunsari district located in eastern Nepal documented a high prevalence of borderline and definite RHD, which was 10·2 (95% CI: 7·5–13·0) per 1000 children. 5 The study used echocardiography as a screening method.…”

Predictor of mitral valve regurgitation severity and left ventricular dilatation using amino-terminal pro-brain natriuretic peptide marker in pediatric rheumatic heart disease

“…Meanwhile, echo-based screening for children with RHD in school revealed a higher prevalence of RHD in girls, but there was no significant difference. [ 14 ] The relationship between RHD and gender in unclear, but intrinsic factor such as autoimmune sensitivities and extrinsic factors such as greater exposure to group A beta-hemolytic streptococcal infections in female may explain this relationship. [ 15 ]…”

Rheumatic heart disease in the heart of Himalayas

“…A large epidemiological survey among school children in the capital Kathmandu valley reported the prevalence to be 0.90 per thousand (in the age group 5–16 years) which was significantly lower than the prevalence in a remote western district Jajarkot having the prevalence of 7.32 per thousand schoolchildren. This showed the alarming prevalence in underprivileged children living in resource constrained environment and poor access to health care on the one hand and underlined the success of primary and secondary prevention programs in the capital on the other [ 6 , 7 ]. Other studies reported the prevalence of definite RHD as 1.66% in schoolchildren in central Nepal and 1 in 100 schoolchildren in Eastern Nepal [ 8 , 9 ].…”