title: Survey of rheumatic heart disease in school children of Kinshasa town.
abstract: OBJECTIVE
  To determine the prevalence of rheumatic heart disease and study the association of this disease to factor such as personal host and environment.
  
  
  METHODS
  A cross sectional survey was carried out by a specially trained medical team.
  
  
  METHODS
  The study involved high risk school children aged 5-16 years from Binza-Kinshasa urban area and adjoining slums in semi-urban area of Kinshasa town.
  
  
  METHODS
  A total of 4848 children randomly selected on the list of semi-urban and urban schools and representing 10% of the schools population were included in the survey with clinical echocardiographic examinations.
  
  
  RESULTS
  Of the 4848 children screened, prevalence of rheumatic heart disease was 14.03/1000. The prevalence was significantly greater in slums schools (22.2/1000) than in urban school (4/1000). In slums area, the mitral valve was the valve most commonly affected by rheumatic heart disease. Risk factors such as birth in rainy season (RR=2.2), low birth weight (RR=1.81), low socioeconomic status (RR=2.68), malnutrition<mean BMI-1 SD (RR=2.64), crowding>8 persons/household (RR=4.10) and migrant status (RR=4.79) predicted significantly rheumatic heart disease occurrence in children living in the semi-urban area (slums). Only birth in rainy season (RR=3.24) predicted significantly rheumatic heart disease onset in children having residence in the urban area.
  
  
  CONCLUSIONS
  Rheumatic heart disease runs a more severe course in Kinshasa, because appropriate medical care, sanitary conditions, primary and secondary prophylaxis are not available. Echocardiograpy is necessary to identify cases of rheumatic heart disease.
authors.affiliation: Centre de cardiologie au Coeur de l'Afrique, LOMO MEDICAL, Limete, Kinshasa, Republic of Congo.
authors.forename: B
authors.initials: B
authors.lastname: Longo-Mbenza
authors.forename: M
authors.initials: M
authors.lastname: Bayekula
authors.forename: R
authors.initials: R
authors.lastname: Ngiyulu
authors.forename: V E
authors.initials: VE
authors.lastname: Kintoki
authors.forename: N F
authors.initials: NF
authors.lastname: Bikangi
authors.forename: K V
authors.initials: KV
authors.lastname: Seghers
authors.forename: L E
authors.initials: LE
authors.lastname: Lukoki
authors.forename: M F
authors.initials: MF
authors.lastname: Mandundu
authors.forename: M
authors.initials: M
authors.lastname: Manzanza
authors.forename: Y
authors.initials: Y
authors.lastname: Nlandu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011204:Poverty Areas; D015995:Prevalence; D012214:Rheumatic Heart Disease / Q000453:epidemiology*; D012307:Risk Factors; D014505:Urban Population