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Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes

Background: Rheumatic heart disease (RHD) is a major cause of cardiovascular disease in developing nations, leading to more than 230,000 deaths annually. Most patients seek medical care only when long-term structural and hemodynamic complications have already occurred. Echocardiographic screenings e...

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Autores principales: Mapelli, Massimo, Zagni, Paola, Calbi, Valeria, Fusini, Laura, Twalib, Aliku, Ferrara, Roberto, Mattavelli, Irene, Alberghina, Laura, Salvioni, Elisabetta, Opira, Cyprian, Kansiime, Jackson, Tamborini, Gloria, Pepi, Mauro, Agostoni, Piergiuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600298/
https://www.ncbi.nlm.nih.gov/pubmed/36291389
http://dx.doi.org/10.3390/children9101451
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author Mapelli, Massimo
Zagni, Paola
Calbi, Valeria
Fusini, Laura
Twalib, Aliku
Ferrara, Roberto
Mattavelli, Irene
Alberghina, Laura
Salvioni, Elisabetta
Opira, Cyprian
Kansiime, Jackson
Tamborini, Gloria
Pepi, Mauro
Agostoni, Piergiuseppe
author_facet Mapelli, Massimo
Zagni, Paola
Calbi, Valeria
Fusini, Laura
Twalib, Aliku
Ferrara, Roberto
Mattavelli, Irene
Alberghina, Laura
Salvioni, Elisabetta
Opira, Cyprian
Kansiime, Jackson
Tamborini, Gloria
Pepi, Mauro
Agostoni, Piergiuseppe
author_sort Mapelli, Massimo
collection PubMed
description Background: Rheumatic heart disease (RHD) is a major cause of cardiovascular disease in developing nations, leading to more than 230,000 deaths annually. Most patients seek medical care only when long-term structural and hemodynamic complications have already occurred. Echocardiographic screenings ensure the early detection of asymptomatic subjects who could benefit from prophylaxis, monitoring and intervention, when appropriate. The aim of this study is to assess the feasibility of a screening program and the prevalence of RHD in a Ugandan orphanage. Methods: We performed an RHD-focused echocardiogram on all the children (5–14 years old) living in a north Ugandan orphanage. Exams were performed with a portable machine (GE Vivid-I). All the time intervals were recorded (minutes). Results: A total of 163 asymptomatic children were screened over 8 days (medium age 9.1; 46% male; 17% affected by severe motor impairment). The feasibility rate was 99.4%. An average of 20.4 exams were performed per day, with an average of 15.5 images collected per subject. Pathological mitral regurgitation (MR) was found in 5.5% of subjects, while at least two morphological features of RHD were found in 4.3%, leading to 1 “definite RHD” (0.6%) case and 13 “borderline RHD” cases (8.1%). Six congenital heart defects were also noted (3.7%): four atrial septal defects, one coronary artery fistula and one Patent Ductus Arteriosus. Conclusions: We demonstrated the feasibility of an echocardiographic screening for RHD in an orphanage in Uganda. A few factors, such as good clinical and hygienic care, the availability of antibiotics and closeness to a big hospital, may account for the low prevalence of the disease in our population.
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spelling pubmed-96002982022-10-27 Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes Mapelli, Massimo Zagni, Paola Calbi, Valeria Fusini, Laura Twalib, Aliku Ferrara, Roberto Mattavelli, Irene Alberghina, Laura Salvioni, Elisabetta Opira, Cyprian Kansiime, Jackson Tamborini, Gloria Pepi, Mauro Agostoni, Piergiuseppe Children (Basel) Article Background: Rheumatic heart disease (RHD) is a major cause of cardiovascular disease in developing nations, leading to more than 230,000 deaths annually. Most patients seek medical care only when long-term structural and hemodynamic complications have already occurred. Echocardiographic screenings ensure the early detection of asymptomatic subjects who could benefit from prophylaxis, monitoring and intervention, when appropriate. The aim of this study is to assess the feasibility of a screening program and the prevalence of RHD in a Ugandan orphanage. Methods: We performed an RHD-focused echocardiogram on all the children (5–14 years old) living in a north Ugandan orphanage. Exams were performed with a portable machine (GE Vivid-I). All the time intervals were recorded (minutes). Results: A total of 163 asymptomatic children were screened over 8 days (medium age 9.1; 46% male; 17% affected by severe motor impairment). The feasibility rate was 99.4%. An average of 20.4 exams were performed per day, with an average of 15.5 images collected per subject. Pathological mitral regurgitation (MR) was found in 5.5% of subjects, while at least two morphological features of RHD were found in 4.3%, leading to 1 “definite RHD” (0.6%) case and 13 “borderline RHD” cases (8.1%). Six congenital heart defects were also noted (3.7%): four atrial septal defects, one coronary artery fistula and one Patent Ductus Arteriosus. Conclusions: We demonstrated the feasibility of an echocardiographic screening for RHD in an orphanage in Uganda. A few factors, such as good clinical and hygienic care, the availability of antibiotics and closeness to a big hospital, may account for the low prevalence of the disease in our population. MDPI 2022-09-23 /pmc/articles/PMC9600298/ /pubmed/36291389 http://dx.doi.org/10.3390/children9101451 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mapelli, Massimo
Zagni, Paola
Calbi, Valeria
Fusini, Laura
Twalib, Aliku
Ferrara, Roberto
Mattavelli, Irene
Alberghina, Laura
Salvioni, Elisabetta
Opira, Cyprian
Kansiime, Jackson
Tamborini, Gloria
Pepi, Mauro
Agostoni, Piergiuseppe
Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes
title Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes
title_full Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes
title_fullStr Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes
title_full_unstemmed Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes
title_short Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes
title_sort echocardiographic screening for rheumatic heart disease in a ugandan orphanage: feasibility and outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600298/
https://www.ncbi.nlm.nih.gov/pubmed/36291389
http://dx.doi.org/10.3390/children9101451
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