Pediatric rheumatic heart disease in a middle-income country: A population-based study
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-...
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my.um.eprints.334942022-08-01T01:03:40Z http://eprints.um.edu.my/33494/ Pediatric rheumatic heart disease in a middle-income country: A population-based study Zahari, Norazah Yeoh, Si Ling Muniandy, Siva Rao Bah, Mohd Nizam Mat RJ Pediatrics RV Botanic, Thomsonian, and eclectic medicine 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. Oxford Univ Press 2022-01-07 Article PeerReviewed 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 https://doi.org/10.1093/tropej/fmac005 <https://doi.org/10.1093/tropej/fmac005>. 10.1093/tropej/fmac005 |
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RJ Pediatrics RV Botanic, Thomsonian, and eclectic medicine Zahari, Norazah Yeoh, Si Ling Muniandy, Siva Rao Bah, Mohd Nizam Mat Pediatric rheumatic heart disease in a middle-income country: A population-based study |
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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. |
format |
Article |
author |
Zahari, Norazah Yeoh, Si Ling Muniandy, Siva Rao Bah, Mohd Nizam Mat |
author_facet |
Zahari, Norazah Yeoh, Si Ling Muniandy, Siva Rao Bah, Mohd Nizam Mat |
author_sort |
Zahari, Norazah |
title |
Pediatric rheumatic heart disease in a middle-income country: A population-based study |
title_short |
Pediatric rheumatic heart disease in a middle-income country: A population-based study |
title_full |
Pediatric rheumatic heart disease in a middle-income country: A population-based study |
title_fullStr |
Pediatric rheumatic heart disease in a middle-income country: A population-based study |
title_full_unstemmed |
Pediatric rheumatic heart disease in a middle-income country: A population-based study |
title_sort |
pediatric rheumatic heart disease in a middle-income country: a population-based study |
publisher |
Oxford Univ Press |
publishDate |
2022 |
url |
http://eprints.um.edu.my/33494/ |
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1740826036095942656 |
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13.18916 |