Abstract 14044: Prevalence of Rheumatic Heart Disaese in Ugandan School-Aged Population: Implications for Sub-Saharan Africa
Background: The global prevalence of rheumatic heart disease (RHD) is estimated between 15.6 and 30 million based on population-based data, including 1 million sub-Saharan African school-aged children. A paucity of data from sub-Saharan Africa likely contributes to a significant underestimate of the true global burden of RHD. The 2012 World Heart Federation (WHF) echocardiographic guidelines allow for standardized assessment of RHD prevalence. We provide an updated estimate of RHD prevalence based on a large screening effort in northern Uganda.
Methods: Over a 1 week period, children aged 5-16 years at 5 local schools in Gulu, Uganda underwent echocardiography using the 2012 WHF guidelines. Gulu is the third largest city in Uganda with a population of 154,000. The results of this study were extrapolated to 51 other sub-Saharan African countries based on country-by-country population and age distribution. Morocco, Algeria, Tunisia, Libya, Egypt and South Africa were excluded. The prevalence of RHD in sub-Saharan African children of the same age was assumed to be similar to Gulu.
Results: Of 4,773 children screened, 4,561 studies were normal (95.6%), 52 met criteria for definite RHD (1.1%), and 140 met criteria for borderline RHD (2.9%). Of Uganda’s 35.4 million population, 12.1 million are between 5 and 16 years old, resulting in an estimate of definite and borderline RHD in Uganda of 132,704 and 349,856 school-aged children respectively. The total population in the 51 countries included is 852.5 million, with 27.2 million between 5 and 16 years old, resulting in an estimate of definite and borderline RHD in sub-Saharan Africa of 3.0 million and 7.9 million school-aged children respectively.
Conclusion: With systematic echocardiographic screening using 2012 WHF criteria, the estimated number of sub-Saharan African school-aged children with definite RHD is dramatically higher than prior reports, and borderline RHD cases may represent additional burden of disease. This may still be an underestimate, as it excludes children not well enough to attend school. Additionally the prevalance in older children and young adults is likely even higher. More systematic prevalence studies are needed to determine the true global burden of RHD.
Author Disclosures: J. Weinberg: None. A. Beaton: None. J.C. Lu: None. T. Aliku: None. P. Dean: None. L. Gaur: None. J. Godown: None. P. Lwabi: None. G. Mirembe: None. E. Okello: None. A. Reese: None. A. Shrestha Astudillo: None. J. Scheel: None. C. Webb: None. G. Ensing: None. C. Sable: None.
- © 2014 by American Heart Association, Inc.