Echocardiographic Screening of Rheumatic Heart Disease in American Samoa

Jennifer Huang, Michael Favazza, Arthur Legg, Kathryn Holmes, Laurie Armsby, Ipuniuesea Eliapo-Unutoa, Thomas Pilgrim, Erin Madriago

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

While rheumatic heart disease (RHD) is a treatable disease nearly eradicated in the United States, it remains the most common form of acquired heart disease in the developing world. This study used echocardiographic screening to determine the prevalence of RHD in children in American Samoa. Screening took place at a subset of local schools. Private schools were recruited and public schools underwent cluster randomization based on population density. We collected survey information and performed a limited physical examination and echocardiogram using the World Heart Federation protocol for consented school children aged 5–18 years old. Of 2200 students from two private high schools and two public primary schools, 1058 subjects consented and were screened. Overall, 133 (12.9%) children were identified as having either definite (3.5%) or borderline (9.4%) RHD. Of the patients with definitive RHD, 28 subjects had abnormal mitral valves with pathologic regurgitation, three mitral stenosis, three abnormal aortic valves with pathologic regurgitation, and seven borderline mitral and aortic valve disease. Of the subjects with borderline disease, 77 had pathologic mitral regurgitation, 12 pathologic aortic regurgitation, and 7 at least two features of mitral valve disease without pathologic regurgitation or stenosis. Rheumatic heart disease remains a major cause of morbidity and mortality worldwide. The prevalence of RHD in American Samoa (12.9%) is to date the highest reported in the world literature. Echocardiographic screening of school children is feasible, while reliance on murmur and Jones criteria is not helpful in identifying children with RHD.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalPediatric Cardiology
DOIs
StateAccepted/In press - Sep 20 2017

Fingerprint

American Samoa
Rheumatic Heart Disease
Mitral Valve
Aortic Valve
Aortic Diseases
Aortic Valve Insufficiency
Mitral Valve Stenosis
Mitral Valve Insufficiency
Random Allocation
Population Density
Physical Examination
Heart Diseases
Pathologic Constriction
Students
Morbidity

Keywords

  • Echocardiography
  • Global health
  • Pediatric cardiology
  • Rheumatic heart disease
  • Streptococcus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Echocardiographic Screening of Rheumatic Heart Disease in American Samoa. / Huang, Jennifer; Favazza, Michael; Legg, Arthur; Holmes, Kathryn; Armsby, Laurie; Eliapo-Unutoa, Ipuniuesea; Pilgrim, Thomas; Madriago, Erin.

In: Pediatric Cardiology, 20.09.2017, p. 1-7.

Research output: Contribution to journalArticle

Huang, Jennifer ; Favazza, Michael ; Legg, Arthur ; Holmes, Kathryn ; Armsby, Laurie ; Eliapo-Unutoa, Ipuniuesea ; Pilgrim, Thomas ; Madriago, Erin. / Echocardiographic Screening of Rheumatic Heart Disease in American Samoa. In: Pediatric Cardiology. 2017 ; pp. 1-7.
@article{af85ca30ff6741a1bc61c144ac4ef3cf,
title = "Echocardiographic Screening of Rheumatic Heart Disease in American Samoa",
abstract = "While rheumatic heart disease (RHD) is a treatable disease nearly eradicated in the United States, it remains the most common form of acquired heart disease in the developing world. This study used echocardiographic screening to determine the prevalence of RHD in children in American Samoa. Screening took place at a subset of local schools. Private schools were recruited and public schools underwent cluster randomization based on population density. We collected survey information and performed a limited physical examination and echocardiogram using the World Heart Federation protocol for consented school children aged 5–18 years old. Of 2200 students from two private high schools and two public primary schools, 1058 subjects consented and were screened. Overall, 133 (12.9{\%}) children were identified as having either definite (3.5{\%}) or borderline (9.4{\%}) RHD. Of the patients with definitive RHD, 28 subjects had abnormal mitral valves with pathologic regurgitation, three mitral stenosis, three abnormal aortic valves with pathologic regurgitation, and seven borderline mitral and aortic valve disease. Of the subjects with borderline disease, 77 had pathologic mitral regurgitation, 12 pathologic aortic regurgitation, and 7 at least two features of mitral valve disease without pathologic regurgitation or stenosis. Rheumatic heart disease remains a major cause of morbidity and mortality worldwide. The prevalence of RHD in American Samoa (12.9{\%}) is to date the highest reported in the world literature. Echocardiographic screening of school children is feasible, while reliance on murmur and Jones criteria is not helpful in identifying children with RHD.",
keywords = "Echocardiography, Global health, Pediatric cardiology, Rheumatic heart disease, Streptococcus",
author = "Jennifer Huang and Michael Favazza and Arthur Legg and Kathryn Holmes and Laurie Armsby and Ipuniuesea Eliapo-Unutoa and Thomas Pilgrim and Erin Madriago",
year = "2017",
month = "9",
day = "20",
doi = "10.1007/s00246-017-1724-4",
language = "English (US)",
pages = "1--7",
journal = "Pediatric Cardiology",
issn = "0172-0643",
publisher = "Springer New York",

}

TY - JOUR

T1 - Echocardiographic Screening of Rheumatic Heart Disease in American Samoa

AU - Huang, Jennifer

AU - Favazza, Michael

AU - Legg, Arthur

AU - Holmes, Kathryn

AU - Armsby, Laurie

AU - Eliapo-Unutoa, Ipuniuesea

AU - Pilgrim, Thomas

AU - Madriago, Erin

PY - 2017/9/20

Y1 - 2017/9/20

N2 - While rheumatic heart disease (RHD) is a treatable disease nearly eradicated in the United States, it remains the most common form of acquired heart disease in the developing world. This study used echocardiographic screening to determine the prevalence of RHD in children in American Samoa. Screening took place at a subset of local schools. Private schools were recruited and public schools underwent cluster randomization based on population density. We collected survey information and performed a limited physical examination and echocardiogram using the World Heart Federation protocol for consented school children aged 5–18 years old. Of 2200 students from two private high schools and two public primary schools, 1058 subjects consented and were screened. Overall, 133 (12.9%) children were identified as having either definite (3.5%) or borderline (9.4%) RHD. Of the patients with definitive RHD, 28 subjects had abnormal mitral valves with pathologic regurgitation, three mitral stenosis, three abnormal aortic valves with pathologic regurgitation, and seven borderline mitral and aortic valve disease. Of the subjects with borderline disease, 77 had pathologic mitral regurgitation, 12 pathologic aortic regurgitation, and 7 at least two features of mitral valve disease without pathologic regurgitation or stenosis. Rheumatic heart disease remains a major cause of morbidity and mortality worldwide. The prevalence of RHD in American Samoa (12.9%) is to date the highest reported in the world literature. Echocardiographic screening of school children is feasible, while reliance on murmur and Jones criteria is not helpful in identifying children with RHD.

AB - While rheumatic heart disease (RHD) is a treatable disease nearly eradicated in the United States, it remains the most common form of acquired heart disease in the developing world. This study used echocardiographic screening to determine the prevalence of RHD in children in American Samoa. Screening took place at a subset of local schools. Private schools were recruited and public schools underwent cluster randomization based on population density. We collected survey information and performed a limited physical examination and echocardiogram using the World Heart Federation protocol for consented school children aged 5–18 years old. Of 2200 students from two private high schools and two public primary schools, 1058 subjects consented and were screened. Overall, 133 (12.9%) children were identified as having either definite (3.5%) or borderline (9.4%) RHD. Of the patients with definitive RHD, 28 subjects had abnormal mitral valves with pathologic regurgitation, three mitral stenosis, three abnormal aortic valves with pathologic regurgitation, and seven borderline mitral and aortic valve disease. Of the subjects with borderline disease, 77 had pathologic mitral regurgitation, 12 pathologic aortic regurgitation, and 7 at least two features of mitral valve disease without pathologic regurgitation or stenosis. Rheumatic heart disease remains a major cause of morbidity and mortality worldwide. The prevalence of RHD in American Samoa (12.9%) is to date the highest reported in the world literature. Echocardiographic screening of school children is feasible, while reliance on murmur and Jones criteria is not helpful in identifying children with RHD.

KW - Echocardiography

KW - Global health

KW - Pediatric cardiology

KW - Rheumatic heart disease

KW - Streptococcus

UR - http://www.scopus.com/inward/record.url?scp=85029583611&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029583611&partnerID=8YFLogxK

U2 - 10.1007/s00246-017-1724-4

DO - 10.1007/s00246-017-1724-4

M3 - Article

SP - 1

EP - 7

JO - Pediatric Cardiology

JF - Pediatric Cardiology

SN - 0172-0643

ER -