Echocardiographic prevalence of rheumatic heart disease in Brazilian schoolchildren: Data from the PROVAR study - PubMed Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep 15:219:439-45.
doi: 10.1016/j.ijcard.2016.06.088. Epub 2016 Jun 23.

Echocardiographic prevalence of rheumatic heart disease in Brazilian schoolchildren: Data from the PROVAR study

Bruno R Nascimento  1 , Andrea Z Beaton  2 , Maria Carmo P Nunes  3 , Adriana C Diamantino  4 , Gabriel A L Carmo  3 , Kaciane K B Oliveira  4 , Cassio M Oliveira  4 , Zilda Maria A Meira  3 , Sandra Regina T Castilho  3 , Eduardo L V Lopes  5 , Iara M Castro  5 , Vitória M L R Rezende  5 , Graziela Chequer  3 , Taylor Landay  2 , Allison Tompsett  2 , Antônio Luiz P Ribeiro  3 , Craig Sable  2 ; PROVAR (Programa de RastreamentO da VAlvopatia Reumática) investigators
Affiliations

Echocardiographic prevalence of rheumatic heart disease in Brazilian schoolchildren: Data from the PROVAR study

Bruno R Nascimento et al. Int J Cardiol. .

Abstract

Background: Accurate estimates of Rheumatic Heart Disease (RHD) burden are needed to justify improved integration of RHD prevention and screening into the public health systems, but data from Latin America are still sparse.

Objective: To determine the prevalence of RHD among socioeconomically disadvantaged youth (5-18years) in Brazil and examine risk factors for the disease.

Methods: The PROVAR program utilizes non-expert screeners, telemedicine, and handheld and standard portable echocardiography to conduct echocardiographic screening in socioeconomically disadvantaged schools in Minas Gerais, Brazil. Cardiologists in the US and Brazil provide expert interpretation according to the 2012 World Heart Federation Guidelines. Here we report prevalence data from the first 14months of screening, and examine risk factors for RHD.

Results: 5996 students were screened across 21 schools. Median age was 11.9 [9.0/15.0] years, 59% females. RHD prevalence was 42/1000 (n=251): 37/1000 borderline (n=221) and 5/1000 definite (n=30). Pathologic mitral regurgitation was observed in 203 (80.9%), pathologic aortic regurgitation in 38 (15.1%), and mixed mitral/aortic valve disease in 10 (4.0%) children. Older children had higher prevalence (50/1000 vs. 28/1000, p<0.001), but no difference was observed between northern (lower resourced) and central areas (34/1000 vs. 44/1000, p=0.31). Females had higher prevalence (48/1000 vs. 35/1000, p=0.016). Age (OR=1.15, 95% CI:1.10-1.21, p<0.001) was the only variable independently associated with RHD findings.

Conclusions: RHD continues to be an important and under recognized condition among socioeconomically disadvantaged Brazilian schoolchildren. Our data adds to the compelling case for renewed investment in RHD prevention and early detection in Latin America.

Keywords: Echocardiography; Rheumatic heart disease; Screening; Telemedicine.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

LinkOut - more resources