Subclinical rheumatic heart disease in an Eritrean high-school population, detected by echocardiography.

BACKGROUND AND AIM OF THE STUDY: In developing countries rheumatic heart disease (RHD) is still the most common acquired cardiovascular disease affecting children and young adults. The study aim was to investigate, via an echocardiographic screening, the prevalence of subclinical RHD in high-school students in Eritrea.

METHODS: A total of 684 students (314 females, 370 males; mean age 16.7 years) was randomly selected from nine secondary high schools in different regions of Eritrea to assess, via clinical and echocardiographic examinations, the presence of subclinical RHD. The term 'subclinical' was used to define the disease at its early stage, when it could not be detected by clinical examination only.

RESULTS: Evidence of RHD was found in 28 students (4%), and of suspected RHD in 23 students (3.3%). Only 26 students (51%) with RHD (both evident or suspected) had a murmur at cardiac auscultation, and only 25 (49%) had a history of previous sore throat and tonsillitis. No student had clinical symptoms. All students with evident or suspected RHD were sent to secondary prophylaxis.

CONCLUSION: Despite involving only a limited population sample, the present study confirmed that, in Eritrea, there is a high prevalence (4%) of RHD among high-school-aged students. The data acquired demonstrated the importance of a clinical and echocardiographic surveillance, and the need to start a preventive campaign for rheumatic fever and RHD in this country. This has now been commenced in Eritrean primary schools, with the collaboration of local teachers.