Introduction:
In low-income nations, rheumatic heart disease (RHD) remains a major
cause of morbidity and premature death and imposes a substantial burden
on health care systems with limited budgets (1,2).
Nevertheless, primary and secondary prevention efforts may be highly
effective (1,3). Secondary prevention relies on
accurate case detection for the appropriate use of prophylactic
antibiotics and regular medical surveillance. Exact prevalence data are
also highly desirable to facilitate health care planning.
Rheumatic Heart disease continues to be a major health problem in many
parts of the world particularly developing countries including Egypt.
While it has been eliminated from developed countries and we aim that
Egypt has to go in the same direction and get rid from this disabling
major health problem as it remains a significant cause of cardiovascular
morbidity and mortality. The most devastating effects are on children
and young adults and the first acquired cardiovascular disease in this
health group (2,3).
For at least five decades this unique non-supportive sequel to group A
streptococcal infections has been a concern of the World Health
Organization (WHO) and its member countries. Sentinel studies conducted
under the auspices of the WHO during the last four decades clearly
documented that the control of the preceding infections and their
sequelae is both cost effective and inexpensive. Without doubt,
appropriate public health control programs and optimal medical care
reduce the burden of the disease. RHD accounts for 25-50 % of all
cardiac admissions in developing countries and is considered a major
health concern including the middle east, the Indian subcontinent and
south America. As many as 20 million occur each year; 233 thousand die
each year as a result of RHD. Estimated 12 million patients worldwide
required further treatment to prevent disability and death and about 8
million school children require further treatment to prevent morbidity
and mortality (4-8).
In Egypt there is no national data yet for the prevalence of RHD which
makes any action plan for combating, preventing and eliminating this
major health problem is difficult. In WHO disability adjusted life years
(DALYs) lost (the sum of years of life lost owing to premature death,
plus the years lived with disability adjusted for the severity of the
disability) remains much higher in the Eastern Mediterranean zone, to
which Egypt geographically belongs, coming only second after South-East
Asia (9).
We aim from this population-based study to detect the prevalence and
patterns of RHD affection among school children in Suez Canal region
using echocardiographic screening by screening (primary, preparatory and
secondary schools) representing urban and rural regions as a precursor
for nationwide survey.