Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening Study
Background: Rheumatic heart disease (RHD) in sub-Saharan Africa contributes to significant cardiac morbidity and mortality, yet prevalence estimates of RHD lesions in pregnancy are lacking. Objectives: Our first aim was to evaluate women using echocardiography to estimate the prevalence of RHD and o...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2021-02-01
|
| Series: | Global Heart |
| Subjects: | |
| Online Access: | https://globalheartjournal.com/articles/826 |
| _version_ | 1818667640221073408 |
|---|---|
| author | John W. Snelgrove Joy Marsha Alera Michael C. Foster Kipchumba C. N. Bett Gerald S. Bloomfield Candice K. Silversides Felix A. Barasa Astrid Christoffersen-Deb Heather C. Millar Julie G. Thorne Rachel F. Spitzer Rajesh Vedanthan Nanette Okun |
| author_facet | John W. Snelgrove Joy Marsha Alera Michael C. Foster Kipchumba C. N. Bett Gerald S. Bloomfield Candice K. Silversides Felix A. Barasa Astrid Christoffersen-Deb Heather C. Millar Julie G. Thorne Rachel F. Spitzer Rajesh Vedanthan Nanette Okun |
| author_sort | John W. Snelgrove |
| collection | DOAJ |
| description | Background: Rheumatic heart disease (RHD) in sub-Saharan Africa contributes to significant cardiac morbidity and mortality, yet prevalence estimates of RHD lesions in pregnancy are lacking. Objectives: Our first aim was to evaluate women using echocardiography to estimate the prevalence of RHD and other cardiac lesions in low-risk pregnancies. Our second aim was to assess the feasibility of screening echocardiography and its acceptability to patients. Methods: We prospectively recruited 601 pregnant women from a low-risk antenatal clinic at a tertiary care maternity centre in Western Kenya. Women completed a questionnaire about past medical history and cardiac symptoms. They underwent standardized screening echocardiography to evaluate RHD and non-RHD associated cardiac lesions. Our primary outcome was RHD-associated cardiac lesions and our secondary outcome was a composite of any clinically-relevant cardiac lesion or echocardiography finding. We also recorded duration of screening echocardiography and its acceptability among pregnant women in this sample. Results: The point prevalence of RHD-associated cardiac lesions was 5.0/1,000 (95% confidence interval: 1.0–14.5), and the point prevalence of all clinically significant lesions/findings was 21.6/1,000 (11.6–36.7). Mean screening time was seven minutes (SD 1.7, range: 4–17) for women without cardiac abnormalities and 13 minutes (SD 4.6, range: 6–23) for women with abnormal findings. Echocardiography was acceptable to women with 74.2% agreeing to participate. Conclusions: The prevalence of clinically-relevant cardiac lesions was moderately high in a low-risk population of pregnant women in Western Kenya. |
| first_indexed | 2024-12-17T06:23:38Z |
| format | Article |
| id | doaj.art-28c143dc66db42828ef4edd0ef094c34 |
| institution | Directory Open Access Journal |
| issn | 2211-8179 |
| language | English |
| last_indexed | 2024-12-17T06:23:38Z |
| publishDate | 2021-02-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Global Heart |
| spelling | doaj.art-28c143dc66db42828ef4edd0ef094c342022-12-21T22:00:21ZengUbiquity PressGlobal Heart2211-81792021-02-0116110.5334/gh.826821Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening StudyJohn W. Snelgrove0Joy Marsha Alera1Michael C. Foster2Kipchumba C. N. Bett3Gerald S. Bloomfield4Candice K. Silversides5Felix A. Barasa6Astrid Christoffersen-Deb7Heather C. Millar8Julie G. Thorne9Rachel F. Spitzer10Rajesh Vedanthan11Nanette Okun12Division of Maternal-Fetal Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, OntarioDirectorate of Reproductive Health, Moi Teaching and Referral Hospital, Eldoret; Academic Model Providing Access to Healthcare (AMPATH), EldoretHeart Center, Duke University Medical Center, Durham, NCDirectorate of Reproductive Health, Moi Teaching and Referral Hospital, Eldoret; Academic Model Providing Access to Healthcare (AMPATH), EldoretHeart Center, Duke University Medical Center, Durham, NC; Department of Medicine, Duke Clinical Research Institute and Duke Global Health Institute, Duke University, Durham, NCDivision of Cardiology, Department of Medicine, Mount Sinai Hospital/Toronto General Hospital, University of Toronto, Toronto, ONDepartment of Cardiology, Moi Teaching and Referral Hospital, EldoretDirectorate of Reproductive Health, Moi Teaching and Referral Hospital, Eldoret; Academic Model Providing Access to Healthcare (AMPATH), Eldoret, KE; Department of Obstetrics and Gynaecology, BC Children’s Hospital, University of British Columbia, Vancouver, BCDepartment of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, CA; Directorate of Reproductive Health, Moi Teaching and Referral Hospital, Eldoret; Academic Model Providing Access to Healthcare (AMPATH), EldoretDepartment of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, CA; Directorate of Reproductive Health, Moi Teaching and Referral Hospital, Eldoret; Academic Model Providing Access to Healthcare (AMPATH), EldoretDepartment of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, OntarioSection for Global Health, Department of Population Health, New York University School of Medicine, New York, NYDivision of Maternal-Fetal Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, OntarioBackground: Rheumatic heart disease (RHD) in sub-Saharan Africa contributes to significant cardiac morbidity and mortality, yet prevalence estimates of RHD lesions in pregnancy are lacking. Objectives: Our first aim was to evaluate women using echocardiography to estimate the prevalence of RHD and other cardiac lesions in low-risk pregnancies. Our second aim was to assess the feasibility of screening echocardiography and its acceptability to patients. Methods: We prospectively recruited 601 pregnant women from a low-risk antenatal clinic at a tertiary care maternity centre in Western Kenya. Women completed a questionnaire about past medical history and cardiac symptoms. They underwent standardized screening echocardiography to evaluate RHD and non-RHD associated cardiac lesions. Our primary outcome was RHD-associated cardiac lesions and our secondary outcome was a composite of any clinically-relevant cardiac lesion or echocardiography finding. We also recorded duration of screening echocardiography and its acceptability among pregnant women in this sample. Results: The point prevalence of RHD-associated cardiac lesions was 5.0/1,000 (95% confidence interval: 1.0–14.5), and the point prevalence of all clinically significant lesions/findings was 21.6/1,000 (11.6–36.7). Mean screening time was seven minutes (SD 1.7, range: 4–17) for women without cardiac abnormalities and 13 minutes (SD 4.6, range: 6–23) for women with abnormal findings. Echocardiography was acceptable to women with 74.2% agreeing to participate. Conclusions: The prevalence of clinically-relevant cardiac lesions was moderately high in a low-risk population of pregnant women in Western Kenya.https://globalheartjournal.com/articles/826rheumatic heart diseasepregnancyechocardiographyepidemiologykenyaafrica |
| spellingShingle | John W. Snelgrove Joy Marsha Alera Michael C. Foster Kipchumba C. N. Bett Gerald S. Bloomfield Candice K. Silversides Felix A. Barasa Astrid Christoffersen-Deb Heather C. Millar Julie G. Thorne Rachel F. Spitzer Rajesh Vedanthan Nanette Okun Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening Study Global Heart rheumatic heart disease pregnancy echocardiography epidemiology kenya africa |
| title | Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening Study |
| title_full | Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening Study |
| title_fullStr | Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening Study |
| title_full_unstemmed | Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening Study |
| title_short | Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening Study |
| title_sort | prevalence of rheumatic heart disease and other cardiac conditions in low risk pregnancies in kenya a prospective echocardiography screening study |
| topic | rheumatic heart disease pregnancy echocardiography epidemiology kenya africa |
| url | https://globalheartjournal.com/articles/826 |
| work_keys_str_mv | AT johnwsnelgrove prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT joymarshaalera prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT michaelcfoster prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT kipchumbacnbett prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT geraldsbloomfield prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT candiceksilversides prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT felixabarasa prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT astridchristoffersendeb prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT heathercmillar prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT juliegthorne prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT rachelfspitzer prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT rajeshvedanthan prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy AT nanetteokun prevalenceofrheumaticheartdiseaseandothercardiacconditionsinlowriskpregnanciesinkenyaaprospectiveechocardiographyscreeningstudy |