Pediatric rheumatic heart disease in a middle-income country: A population-based study

Zahari, Norazah and Yeoh, Si Ling and Muniandy, Siva Rao and Bah, Mohd Nizam Mat (2022) Pediatric rheumatic heart disease in a middle-income country: A population-based study. Journal of Tropical Pediatrics, 68 (1). ISSN 0142-6338, DOI

Full text not available from this repository.


Introduction Rheumatic heart disease (RHD), a debilitating complication from rheumatic fever, remains a problem in low- and middle-income countries. This study describes the incidence, prevalence, modifiable risk factors for severe RHD and immediate outcome of pediatric RHD. Methods This population-based and observational cohort study reviewed pediatric RHD patients (0-18 years) from the Sabah Pediatric Rheumatic Heart Registry from 2015 till 2018. Results A total of 188 RHD were reviewed with 120 new cases. The incidence of RHD is 2.19 95% confidence interval (CI): 1.83-2.61] per 100 000 population, with a rising trend over time. Meanwhile, the prevalence of RHD was 13.78 (95% CI: 11.92-15.86) per 100 000 pediatric population. The majority of patients were from indigenous groups (59.0%), male (56.4%) with a mean age of 14.3 (3.31) years. About 77.9% had the lowest household income, and a significant proportion lived in overcrowded conditions. At diagnosis, 59% were diagnosed with severe RHD. There is heightened risk but no statistical significance between modifiable factors (low weight and height percentile at diagnosis, lowest income group, renting a house, overcrowding and healthcare access of more than 5 km) with severe RHD. Severe RHD is significantly associated with risk for intervention (p = 0.016). Sixteen (13.8%) patients required surgical intervention. About 97.6% of patients were on intramuscular benzathine penicillin G with 84.5% compliance. Conclusion The rising prevalence and incidence of pediatric RHD in Sabah, with the most being severe RHD at diagnosis, necessitates the development of an echocardiographic screening and a comprehensive national disease program.

Item Type: Article
Funders: None
Uncontrolled Keywords: Pediatric rheumatic heart disease; Prevalence; Risk factors; Severe RHD; Middle-income country
Subjects: R Medicine > RJ Pediatrics
R Medicine > RV Botanic, Thomsonian, and eclectic medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 01 Aug 2022 01:03
Last Modified: 01 Aug 2022 01:03

Actions (login required)

View Item View Item