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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| Format: | Article |
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MDPI AG
2022-09-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/10/1451 |
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| author | Massimo Mapelli Paola Zagni Valeria Calbi Laura Fusini Aliku Twalib Roberto Ferrara Irene Mattavelli Laura Alberghina Elisabetta Salvioni Cyprian Opira Jackson Kansiime Gloria Tamborini Mauro Pepi Piergiuseppe Agostoni |
| author_facet | Massimo Mapelli Paola Zagni Valeria Calbi Laura Fusini Aliku Twalib Roberto Ferrara Irene Mattavelli Laura Alberghina Elisabetta Salvioni Cyprian Opira Jackson Kansiime Gloria Tamborini Mauro Pepi Piergiuseppe Agostoni |
| author_sort | Massimo Mapelli |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-09T20:28:18Z |
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| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T20:28:18Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-87744adedc6546aeac021e5c540a8d5f2023-11-23T23:31:12ZengMDPI AGChildren2227-90672022-09-01910145110.3390/children9101451Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and OutcomesMassimo Mapelli0Paola Zagni1Valeria Calbi2Laura Fusini3Aliku Twalib4Roberto Ferrara5Irene Mattavelli6Laura Alberghina7Elisabetta Salvioni8Cyprian Opira9Jackson Kansiime10Gloria Tamborini11Mauro Pepi12Piergiuseppe Agostoni13Centro Cardiologico Monzino, IRCCs, Via Parea 4, 20138 Milan, ItalyTerapia Intensiva Neonatale, Ospedale Fatebenefratelli P.O. Macedonio Melloni, Via Macedonio Melloni 52, 20129 Milan, ItalySan Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, ItalyCentro Cardiologico Monzino, IRCCs, Via Parea 4, 20138 Milan, ItalyDivision of Paediatric Cardiology Uganda Heart Institute, Mulago Hospital and Complex, Kampala P.O. Box 37392, UgandaMolecular Immunology Unit, Medical Oncology Department—Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20132 Milan, ItalyCentro Cardiologico Monzino, IRCCs, Via Parea 4, 20138 Milan, ItalyDepartment of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, 20132 Milan, ItalyCentro Cardiologico Monzino, IRCCs, Via Parea 4, 20138 Milan, ItalyHospital Lacor, Gulu P.O. Box 180, UgandaHospital Lacor, Gulu P.O. Box 180, UgandaCentro Cardiologico Monzino, IRCCs, Via Parea 4, 20138 Milan, ItalyCentro Cardiologico Monzino, IRCCs, Via Parea 4, 20138 Milan, ItalyCentro Cardiologico Monzino, IRCCs, Via Parea 4, 20138 Milan, ItalyBackground: 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.https://www.mdpi.com/2227-9067/9/10/1451rheumatic heart diseaserheumatic fevermitral valveechocardiographic screeningdeveloping countries |
| spellingShingle | Massimo Mapelli Paola Zagni Valeria Calbi Laura Fusini Aliku Twalib Roberto Ferrara Irene Mattavelli Laura Alberghina Elisabetta Salvioni Cyprian Opira Jackson Kansiime Gloria Tamborini Mauro Pepi Piergiuseppe Agostoni Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes Children rheumatic heart disease rheumatic fever mitral valve echocardiographic screening developing countries |
| 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 | rheumatic heart disease rheumatic fever mitral valve echocardiographic screening developing countries |
| url | https://www.mdpi.com/2227-9067/9/10/1451 |
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