title: Child and teacher acceptability of school-based echocardiographic screening for rheumatic heart disease in Uganda.
abstract: Introduction Rheumatic heart disease causes substantial morbidity in children in low-income countries. School-based echocardiographic screening has been suggested as a means to identify children with latent disease; however, little is known about the experience of children and teachers participating in screenings. The aim of our study was to assess students' and teachers' experience of school-based echocardiographic screening and identify areas for improvement. Materials and methods A school-based echocardiographic screening programme was conducted in five schools in Northern Uganda in 2013. After 8 months, an age- and gender-stratified population that included 5% of the participating students and teachers completed a questionnaire via an in-person interview. Responses were reviewed by question and coded to identify key themes.
  
  
  RESULTS
  A total of 255 students (mean 10.7 years; 48% male) and 35 teachers participated in our study. In total, 95% of the students and 100% of the teachers were happy to have participated in the screening; however, students reported feeling scared (35%) and nervous (48%) during the screening process. Programmatic strengths included the following: knowing one's health status, opportunity to receive treatment, and staff interactions. Although 43% of the patients did not suggest a change with open-ended questioning, concerns regarding privacy, fear of the screening process, and a desire to include others in the community were noted. Discussion School-based echocardiographic rheumatic heart disease screening was well received by students and teachers. Future programmes would likely benefit from improved pre-screening education regarding the screening process and diagnosis of rheumatic heart disease. Furthermore, education of teachers and students could improve screening perception and establish realistic expectations regarding the scope of screening.
authors.affiliation: 1Division of Cardiology,Children's National Health System,Washington,District of Columbia,United States of America.
authors.forename: Michelle
authors.initials: M
authors.lastname: Ploutz
authors.affiliation: 2Division of Pediatric Cardiology,Gulu Regional Referral Hospital,Gulu,Uganda.
authors.forename: Twalib
authors.initials: T
authors.lastname: Aliku
authors.affiliation: 1Division of Cardiology,Children's National Health System,Washington,District of Columbia,United States of America.
authors.forename: Tyler
authors.initials: T
authors.lastname: Bradley-Hewitt
authors.affiliation: 3University of St Augustine,Austin,Texas,United States of America.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dantin
authors.affiliation: 1Division of Cardiology,Children's National Health System,Washington,District of Columbia,United States of America.
authors.forename: Bethan
authors.initials: B
authors.lastname: Lemley
authors.affiliation: 4AARP Public Policy Institute,Washington,District of Columbia,United States of America.
authors.forename: Catherine W
authors.initials: CW
authors.lastname: Gillespie
authors.affiliation: 5Division of Pediatric Cardiology,Uganda Heart Institute,Kampala,Uganda.
authors.forename: Peter
authors.initials: P
authors.lastname: Lwabi
authors.affiliation: 1Division of Cardiology,Children's National Health System,Washington,District of Columbia,United States of America.
authors.forename: Craig
authors.initials: C
authors.lastname: Sable
authors.affiliation: 1Division of Cardiology,Children's National Health System,Washington,District of Columbia,United States of America.
authors.forename: Andrea
authors.initials: A
authors.lastname: Beaton
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D002593:Cetrimonium Compounds; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009226:Myristates; D009539:Nicotinic Acids; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000175:diagnosis* / Q000453:epidemiology; D012574:Schools; D012841:Simethicone; D013229:Stearic Acids; D013334:Students; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology
chemical_list: D002593:Cetrimonium Compounds; D004338:Drug Combinations; D009226:Myristates; D009539:Nicotinic Acids; D013229:Stearic Acids; C058060:Prevasore; D012841:Simethicone
keywords: Rheumatic heart disease; echocardiography; quality improvement; screening