title: Prevalence of rheumatic valvular heart disease in Rwandan school children: echocardiographic evaluation using the World Heart Federation criteria.
abstract: BACKGROUND
  Rheumatic fever (RF) and rheumatic valvular heart disease (RHD) remain important medical, surgical and public health concerns in many parts of the world, especially in sub-Saharan Africa. However, there are no published data from Rwanda. We performed a RHD prevalence study in a randomly selected sample of Rwandan school children using the 2012 World Heart Federation (WHF) criteria.
  
  
  METHODS
  Echocardiographic assessment of 2 501 Rwandan school children from 10 schools in the Gasabo district near Kigali was carried out. Resulting data were evaluated by four experienced echocardiographers. Statistical analyses were carried out by statisticians.
  
  
  RESULTS
  RHD prevalence was 6.8/1 000 children examined (95% CI: 4.2/1 000-10.9/1 000). Seventeen met WHF criteria for RHD, 13 fulfilled criteria for 'borderline' RHD and four were 'definite' RHD. None of these 17 had been previously identified.
  
  
  CONCLUSIONS
  These data indicate a significant burden of RHD in Rwanda and support a need for defined public health RF control programmes in children there.
authors.affiliation: Rwandan Heart Foundation and Department of Pediatrics, King Faisal Hospital, Kigali, Rwanda.
authors.forename: J
authors.initials: J
authors.lastname: Mucumbitsi
authors.affiliation: Noninvasive Cardiovascular Research, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: B
authors.initials: B
authors.lastname: Bulwer
authors.affiliation: College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
authors.forename: L
authors.initials: L
authors.lastname: Mutesa
authors.affiliation: School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
authors.forename: V
authors.initials: V
authors.lastname: Ndahindwa
authors.affiliation: Rwanda Biomedical Centre, Kigali, Rwanda; Interuniversity Institute for Biostatistical and Statistical Bioinformatics, University of Hasselt, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Semakula
authors.affiliation: School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda.
authors.forename: E
authors.initials: E
authors.lastname: Rusingiza
authors.affiliation: Department of Pediatric Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: P
authors.initials: P
authors.lastname: Arya
authors.affiliation: Massachusetts General Hospital, Institute of Health Professions, Boston, Massachusetts, USA.
authors.forename: S
authors.initials: S
authors.lastname: Breakey
authors.affiliation: Team Heart Inc, Boston, Massachusetts, USA.
authors.forename: C
authors.initials: C
authors.lastname: Patton-Bolman
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA. Email: kapla001@umn.edu.
authors.forename: E L
authors.initials: EL
authors.lastname: Kaplan
mesh_terms: D000293:Adolescent; D002648:Child; D004452:Echocardiography / Q000379:methods; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D044382:Population Groups; D015995:Prevalence; D012213:Rheumatic Fever / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012214:Rheumatic Heart Disease / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012307:Risk Factors; D012432:Rwanda / Q000453:epidemiology