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Prevalence of Rheumatic Heart Disease in School Children of Urban Lahore
  1. Masood Sadiq (drmasoodsadiq{at}hotmail.com)
  1. Punjab institute of Cardiology, Lahore, Pakistan
    1. K Islam
    1. Punjab institute of Cardiology, Lahore, Pakistan
      1. R Abid
      1. Punjab institute of Cardiology, Lahore, Pakistan
        1. F Latif (drfarhanlatif{at}hotmail.com)
        1. Punjab institute of Cardiology, Lahore, Pakistan
          1. A U Rehamn (drasifrn{at}hotmail.com)
          1. Punjab institute of Cardiology, Lahore, Pakistan
            1. A Waheed
            1. Punjab institute of Cardiology, Lahore, Pakistan
              1. M Azhar (drazhar{at}brain.net.pk)
              1. Punjab institute of Cardiology, Lahore, Pakistan
                1. J S Khan (drjawad{at}wol.net.pk)
                1. Punjab institute of Cardiology, Lahore, Pakistan

                  Abstract

                  Background: There is little if any decline in the occurrence of rheumatic heart disease (RHD) in the developing world. The true prevalence data is lacking from Pakistan as school population studies were performed in pre echocardiography era.

                  Objective: To determine the prevalence of RHD among school children in urban and semi-urban areas of city of Lahore in Pakistan.

                  Methods: A cross sectional survey of school children aged 5-15 years was carried out by a team of cardiologists. A representative sample of seventy Lahore Municipal Corporation schools of urban and semi-urban Lahore was selected. Children were screened for by clinical examination and diagnosis confirmed by echocardiography. Socio-demographic data collection was also done.

                  Results: Of 24980 children screened 986 (3.9%) had a confirmed cardiac lesion. 546 had RHD while 440 had CHD. The prevalence of RHD was 21.9/1000 children screened (95% confidence interval 20.1-23.7). The mean age was 10.7+2.6 years & female male ratio 1.6:1. Mixed mitral valve disease was the commonest (30%), followed by isolated mitral stenosis (28%) and mitral regurgitation (22%). Mitral stenosis was seen at a mean age of 10.8+2.4 years. Majority (92.5%) were unaware of the diagnosis and only 2% were taking rheumatic prophylaxis. All children belonged to low socioeconomic group and 67% were undernourished.

                  Conclusion: Prevalence of RHD in the urban school population of Lahore is among the highest in the world (21.9/1000). The younger age of onset is a special feature and majority are unaware of the diagnosis, hence not receiving the life saving secondary prophylaxis.

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