September 29th – October 5th, 2013
Over the last decade, echocardiography has proved to be the most sensitive tool for early RHD detection. The WHO now supports early detection of RHD through echocardiography in high-prevalence regions. The WHF has published evidence-based guidelines for the echocardiographic diagnosis of RHD. These guidelines were designed for use with a standard portable echo machine.
Despite increasingly affordable standard portable echo machines, the price remains too high for most RHD-endemic countries. Newly available hand-held echo machines could both reduce RHD screening costs and increase the reach of such initiatives to even the most remote settings. The sensitivity and specificity of handheld echocardiography for RHD detection has not been evaluated.
In a little less than one week, teams from Children’s National, University of Michigan, the Uganda Heart Institute, and the local Rotary Club came together to screen almost 5,000 schoolchildren in Gulu, Uganda. Locally the project was approved by Makerere University, the Ugandan Council of Science and Technology, and the Gulu Municipal Council. Four schools were selected for participation and all children who attended those schools had the opportunity to have a focused cardiac echocardiogram using a standard portable echo machine. All children found to have abnormalities as well as a random selection of normal participants also underwent a focused echocardiogram using the handheld echo machine.
Data was collected on 7 standard portable echo machines and on 4 handheld echo machines. Data organization and analysis is currently underway. We will determine sensitivity and specificity of handheld echocardiography for latent RHD detection. Demographic and socioeconomic data was also captured to examine risk factors for latent RHD. Children with RHD or congenital heart disease have been enrolled in follow-up at the Gulu Regional Hospital.
4948 Children Screened
Definite RHD: 1.5%
Borderline RHD: 3%
42 cases of congenital or acquired heart disease
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