Prevalence of rheumatic fever and rheumatic heart disease in Bangladeshi children.

BACKGROUND: Recent prevalence data on rheumatic fever (RF) and rheumatic heart disease (RHD) are lacking in Bangladeshi population.

AIM: We have done this national level cross-sectional survey to determine the prevalence of RF and RHD in Bangladeshi children.

METHODS: Samples were drawn from three out of seven divisions of Bangladesh from both urban and rural areas. Trained and experienced enumerators visited households to suspect cases of RF or RHD in 5-19 years children by asking structured questions on symptoms and signs of RF and RHD (n = 56,827). Then trained doctors again took history and examined them for RF/RHD. RF was defined according to the Modified Jones Criteria 1992. Doppler echocardiography was done to confirm the diagnosis in all suspected cases of RF/RHD.

RESULTS: A total of 36 RF cases (new and old) and 16 Doppler echocardiography confirmed RHD cases were identified. Prevalence of RF and RHD was 0.9 per 1000 (95% confidence interval: 0.7-1.2) while prevalence of RF was 0.6 per 1000 (95% CI: 0.4-0.9) and RHD 0.3 per 1000 (95% CI: 0.2-0.5).

CONCLUSION: Observed prevalence of RF and RHD indicates that RF/RHD is disappearing from Bangladesh. However, studies using new technology of portable echocardiographic screening are needed.