Survey of rheumatic heart disease in school children of Kinshasa town.
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.
Longo-Mbenza
B
B
Centre de cardiologie au Coeur de l'Afrique, LOMO MEDICAL, Limete, Kinshasa, Republic of Congo.
Bayekula
M
M
Ngiyulu
R
R
Kintoki
V E
VE
Bikangi
N F
NF
Seghers
K V
KV
Lukoki
L E
LE
Mandundu
M F
MF
Manzanza
M
M
Nlandu
Y
Y
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