title: Teaching focused echocardiography for rheumatic heart disease screening.
abstract: Screening for rheumatic heart disease (RHD) requires workers skilled in echocardiography, which typically involves prolonged, specialized training. Task shifting echocardiographic screening to nonexpert health workers may be a solution in settings with limited human resources. An 8-week training program was designed to train health workers without any prior experience in focused echocardiography for RHD screening. Seven health workers participated. At the completion of training, the health workers performed unsupervised echocardiography on 16 volunteer children with known RHD status. A pediatric cardiologist assessed image quality. Participants provided qualitative feedback. The quality of echocardiograms were high at completion of training (55 of 56 were adequate for diagnosis) and all cases of RHD were identified. Feedback was strongly positive. Training health workers to perform focused echocardiography for RHD screening is feasible. After systematic testing for accuracy, this training program could be adapted in other settings seeking to expand echocardiographic capabilities.
authors.affiliation: Department of Paediatrics, Centre for International Child Health, University of Melbourne, Melbourne, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Engelman
authors.affiliation: Colonial War Memorial Hospital, Suva, Fiji.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Kado
authors.affiliation: Menzies School of Health Research, Darwin, Australia.
authors.forename: Bo
authors.initials: B
authors.lastname: Reményi
authors.affiliation: Menzies School of Health Research, Darwin, Australia.
authors.forename: Samantha M
authors.initials: SM
authors.lastname: Colquhoun
authors.affiliation: Royal Berkshire Hospital, Reading, United Kingdom.
authors.forename: Caroline
authors.initials: C
authors.lastname: Watson
authors.affiliation: Colonial War Memorial Hospital, Suva, Fiji.
authors.forename: Sera C
authors.initials: SC
authors.lastname: Rayasidamu
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Steer
keywords: Echocardiography; education; mass screening; rheumatic heart disease; task shifting