Although once considered a rarity in the Indian subcontinent, the prevalence of rheumatic heart disease (RHD) is now recognised to be very high, particularly among children and young adults.1 Indeed, such was the severity of the problem in developing countries that in 1982 the World Health Organization/International Society and Federation of Cardiology established a committee to combat the disease over a phased period. As a result, the prevalence of RHD has subsided in certain countries in the Middle East, and in Thailand.2

In contrast to previous sources of data upon which to base the prevalence of RHD (for example, necropsies, general population surveys, insurance data3), prevalence figures over the past five years have been derived almost entirely from school surveys. …