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Abstract
Rheumatic fever and more serious rheumatic heart disease have a great impact on child health in developing countries than industrial countries, it is the major cause of cardiovascular death in pediatric age group.
- The present study was done to detect the prevalence of rheumatic heart disease among the primary school children 6-12 years old in Sharkia government in Egypt.
- Screening survey was done on 5650 student in eleven primary schools in some rural area in Sharkia.
- Careful cardiovascular examination was done for all student and any child with audible heart murmer or has past history of RF was subjected to the following:-
- complete history taking, full clinical examination, laboratory investigations as (ESR, CRP, CBC, ASO titre). Chest x- ray, ECG Echo-Doppler study.
- Twenty four children out of the 5650 children examined were found to have cardiac murmer during screening survey done for this study. Twelve children of them have rheumatic heart disease. (i.e) The prevalence rate of RHD in primary schools in Sharkia is found to be 2.129 per thousand according to the present study.
- The twelve cases were 7 boys and 5 girls, The past history of RF was positive in 6 cases of the twelve cases, one case was presented in the attack during the examination and six cases discovered accidentally during the screening.
- Past history of recurrent tonsillitis was positive in ten cases of this twelve cases.
* The first presentation was arthritis in four cases out of the twelve diagnosed cases of RHD (33.3), six cases discovered accidently (50%) and two cases presented with tonsillitis (16.67) no cases presented with chorea.
- In this study we found the valve lesion was as following:-
- Mitral incompetence in 12 cases (100%), Aortic Incompetence in 4 cases (33.3%), Tricuspid incompetence in 6 cases (50%) and pulmonary incompetence in 2 cases (16.67%)
- Also we found one case of the twelve cases has (MR) alone (8.3%) and nine cases have combined mitral incompetence, aortic incompetence tricuspid incompetence and pulmonary incompe-tence (75%). Two cases have tricuspid regurge with change in the morphology of rheumatic pattern of the mitral valve (16.67).