High prevalence of rheumatic heart disease in schoolchildren detected by echocardiography screening in N ew C aledonia

• Published in: Journal of paediatrics and child health Vol. 49; no. 2; pp. 109 - 114
• Main Authors: Baroux, Noémie, Rouchon, Bernard, Huon, Bertrand, Germain, Agnès, Meunier, Jean‐Michel, D'Ortenzio, Eric
• Format: Journal Article
• Language: English
• Published: 01.02.2013
• ISSN: 1034-4810; 1440-1754
• DOI: 10.1111/jpc.12087

Aim Despite the well‐documented burden of rheumatic heart disease ( RHD ) in several Pacific countries, the disease is poorly understood in N ew C aledonia. The aim of this study was to assess the prevalence of RHD detected by echocardiographic screening in school children. Methods An annual RHD screening programme is conducted by the H ealth and S ocial A gency of N ew C aledonia for school‐aged children in their fourth year of primary school. For the purpose of this study, we used data collected during this echocardiographic screening between 2008 and 2010. Results Of 12 728 children screened, 50.2% were male and the mean age was 9.6 ± 0.6 years. Between 2008 and 2010, 114 children had RHD , corresponding to a prevalence of 8.9 cases per 1000 (95% confidence interval ( CI ) (7.3–10.6)). Prevalence of RHD was higher on the main island outside Greater N oumea (13.7 per 1000; 95% CI (9.8–17.5)) and in the outlying island groups (14.6 per 1000; 95% CI (8.4–20.9)) than in Greater N oumea (5.8 per 1000; 95% CI (4.1–7.5)). RHD was more prevalent in M elanesian children (13.5 per 1000; 95% CI (10.9–16.1)) than in E uropean (1.8 per 1000; 95% CI (0.4–3.1)). Conclusion This study documented a high prevalence of RHD in N ew C aledonia, particularly in districts located outside Noumea and in children of M elanesian heritage. These results uncover a hitherto unknown burden of disease in N ew C aledonia and underline the importance of delivering secondary prophylaxis to reduce the prevalence of RHD .