High prevalence of rheumatic heart disease in schoolchildren detected by echocardiography screening in New Caledonia.
OBJECTIVE
Despite the well-documented burden of rheumatic heart disease (RHD) in several Pacific countries, the disease is poorly understood in New Caledonia. The aim of this study was to assess the prevalence of RHD detected by echocardiographic screening in school children.


METHODS
An annual RHD screening programme is conducted by the Health and Social Agency of New Caledonia for school-aged children in their fourth year of primary school. For the purpose of this study, we used data collected during this echocardiographic screening between 2008 and 2010.


RESULTS
Of 12,728 children screened, 50.2% were male and the mean age was 9.6 ± 0.6 years. Between 2008 and 2010, 114 children had RHD, corresponding to a prevalence of 8.9 cases per 1000 (95% confidence interval (CI) (7.3-10.6)). Prevalence of RHD was higher on the main island outside Greater Noumea (13.7 per 1000; 95% CI (9.8-17.5)) and in the outlying island groups (14.6 per 1000; 95% CI (8.4-20.9)) than in Greater Noumea (5.8 per 1000; 95% CI (4.1-7.5)). RHD was more prevalent in Melanesian children (13.5 per 1000; 95% CI (10.9-16.1)) than in European (1.8 per 1000; 95% CI (0.4-3.1)).


CONCLUSIONS
This study documented a high prevalence of RHD in New Caledonia, particularly in districts located outside Noumea and in children of Melanesian heritage. These results uncover a hitherto unknown burden of disease in New Caledonia and underline the importance of delivering secondary prophylaxis to reduce the prevalence of RHD.
Infectious Diseases Epidemiology Unit, Institut Pasteur of New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia. nbaroux@pasteur.nc
Noémie
N
Baroux
Bernard
B
Rouchon
Bertrand
B
Huon
Agnès
A
Germain
Jean-Michel
JM
Meunier
Eric
E
D'Ortenzio
D000293:Adolescent; D002648:Child; D016001:Confidence Intervals; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D009510:New Caledonia / Q000453:epidemiology; D015995:Prevalence; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012574:Schools; D017678:Sex Distribution