Prevalence of rheumatic heart disease in Senegalese school children: a clinical and echocardiographic screening.
OBJECTIVE
To study the prevalence of rheumatic heart disease (RHD) in schools (locally referred to as 'daaras') located in the city of Dakar and its suburbs using both clinical examination and echocardiography.


METHODS
This is a cross-sectional study conducted from 9 August to 24 December 2011 involving 2019 pupils, aged between 5 and 18 years selected from the 16 'daaras' of the Academic Inspectorate (Inspection d'Académie) of the city of Dakar and its suburbs. Anamnestic, clinical and echocardiographic data were collected and entered into a questionnaire designed for the study. The World Heart Federation criteria for echocardiographic diagnosis were used to diagnose RHD. p<0.05 was considered statistically significant in bivariate analysis.


RESULTS
About 60.1% of the pupils were men and the mean age was 9.7±3.3 years. 10 cases of definite RHD were detected, prevalence being 4.96 per 1000 (95% CI 2.4 to 9.1). This prevalence was five times higher with echocardiographic screening compared with clinical screening. 23 cases (11.4 per 1000) of borderline forms were detected. The populations at risk of definite RHD identified in our study were children over 14 years (p<0.001), those with recurrent sore throat (p=0.003) and those residing in the suburbs of the city of Dakar (p<0.001).


CONCLUSIONS
Our study shows a relatively high prevalence of RHD. Reducing its prevalence should focus on the implementation of appropriate policies, targeting at-risk populations and focusing on raising awareness and early detection.
Cardiology Department of Grand Yoff General Hospital , Dakar , Senegal.
Aliou Alassane
AA
Ngaïdé
Cardiology Department of Grand Yoff General Hospital , Dakar , Senegal.
Alassane
A
Mbaye
Cardiology Department of Aristide Le Dantec Teaching Hospital, Dakar, Senegal; Unités de Formation et de Recherche (UFR), Santé Université Gaston Berger de Saint-Louis, Saint Louis, Sénégal.
Adama
A
Kane
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Mouhamadou Bamba
MB
Ndiaye
Cardiology Department of Aristide Le Dantec Teaching Hospital, Dakar, Senegal; Medical Research Council Unit, Atlantic Boulevard, Fajara, The Gambia.
Modou
M
Jobe
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Malick
M
Bodian
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Momar
M
Dioum
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Simon Antoine
SA
Sarr
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Fatou
F
Aw
Cardiology Department of Grand Yoff General Hospital , Dakar , Senegal.
Prisca Sede
PS
Mbakop
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Fatimata Gatta
FG
Ba
Cardiology Department of Grand Yoff General Hospital , Dakar , Senegal.
Ngoné Diaba
ND
Gaye
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Alioune
A
Tabane
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Mamadou Bassirou
MB
Bah
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Sarah Mouna
SM
Coly
Cardiology Department of Grand Yoff General Hospital , Dakar , Senegal.
Dior
D
Diagne
Cardiology Department of Grand Yoff General Hospital , Dakar , Senegal.
Bouna
B
Diack
Cardiology Department of Aristide Le Dantec Teaching Hospital , Dakar , Senegal.
Maboury
M
Diao
Cardiology Department of Grand Yoff General Hospital , Dakar , Senegal.
Abdoul
A
Kane
VALVULAR DISEASE