الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 144 |  |  |
| | | from | 144 | | |
Abstract
Rheumatic valvular heart disease remains the most common acquired heart disease worldwide. It is the major cause of cardiovascular death in pediatric age group, so an accurate diagnosis of RF is very important.
Although acute rheumatic fever (ARF) has declined in Europe and North America in incidence over the past 4 to 6 decades the disease remains one of the most important causes of cardiovascular morbidity and mortality among socially and economically disadvantaged population all over the world especially in the developing countries that are home to the majority of world’s population. Incidence rates in these countries still reach epidemic levels.
Rheumatic heart disease is a sequela of acute rheumatic fever, which is usually a disease of poverty associated with overcrowding, poor sanitation and other social determinants of poor health. The near elimination of acute rheumatic fever and reduction in the rates of rheumatic heart disease in high-income countries during the late 20th century was attributed in part to improvements in socioeconomic conditions and the widespread use of penicillin G benzathine to treat streptococcal pharyngitis. The remaining burden of rheumatic heart disease is found mostly in low-income and middle-income countries and among immigrants and older adults in high-income countries.
The present study was done to detect the prevalence of rheumatic heart disease among the primary and preparatory school children 6-15 years old in Birket El Saba district, Menoufia governorate in Egypt.
The aim of our present study is to determine the prevalence of rheumatic heart disease in school children in Birket El Saba district, Menoufia governorate. This present study was conducted on 5000 children (2473 males and 2527 females) in 11 primary and 9 preparatory governmental schools in Birket El Saba district (8 urban and 12 rural schools) in the period from November 2015 to November 2017.
In our study detection of prevalence of RHD in school children was done by taking detailed history thorough a questionnairs, full clinical examination and listening for murmurs by stethoscope followed by echocardiographic confirmation only in suspected cases by using the 2012 WHF criteria for detecting RHD and were categorized to definite, borderline and no RHD which reported by (Reményi et al., 2012).
111(2.22%) children out of the 5000 children examined were found to have abnormal history and examination (49 cases had recurrent tonsillitis, 30 cases had arthralgia, 3 cases had arthritis all taking long acting penicillin, 3 cases had positive family history of rheumatic heart disease and 26 cases had discovered murmur during auscultation), 7 cases refused doing echo, the remaining 104 cases did echo, 3 children of them (2.9%) were found to have definite rheumatic valvular heart disease (2 of them were found to have mitral regurgitation and one had aortic regurgitation), 6 children of them (5.76%) were found to have congenital cardiac conditions (2 had mitral valve prolapse with mild MR, 1 had coarcitation of aorta, 1 had subaortic membrane and aortic regurge, 1 had tricuspid regurge and corrected fallot and 1 case had mild pulmonary stenosis). 95 children of them (91.34%) were normal by echocardiography.