Prevalence of congenital and rheumatic heart disease in anganwadi and school going children of vellore, tamil nadu, south india.

ORIGINAL ARTICLE

Prevalence of Congenital and Rheumatic Heart Disease in Anganwadi and School Going Children of Vellore, Tamil Nadu, South India.

B Rupa¹, E Therani Rajan¹, Sivagami¹, S Dheeraj Panchaksharam², S Xavier³.

¹Department of Pediatrics, Government Medical College, Vellore, Tamil Nadu, India,
²CRRI, Government Medical College, Vellore, Tamil Nadu, India,
³Department of Biostatistics, Government Medical College, Vellore, Tamil Nadu, India.

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Abstract
Background: Congenital heart diseases (CHD) cause significant mortality and morbidity in under-5 children. Most cases remain asymptomatic until late childhood. Untreated throat infections in low socioeconomic/remote areas may lead to rheumatic heart disease (RHD). Owing to the inaccessibility of health care and pediatricians in remote and rural areas, Rashtriya Bal Swasthya Karyakram medical officers play an important role in prevention and screening of heart disease in children. This study emphasizes the importance of early cardiac screening of apparently normal children to prevent complications of CHD/RHD in later stages of life.
Objective: The aim of this study was to determine the prevalence of CHD and RHD in apparently normal school going and Anganwadi children of age 6 months-18 years in Vellore, South India, in the calendar year June 2016 to May 2017.
Materials and methods: School going and anganwadi children, between the ages of 6 months-18 years were screened at anganwadis, primary and higher secondary schools in and around Vellore district. The children were clinically examined and evaluated by 2 teams consisting of a Rashtriya Bal Swasthya Karyakram medical officer, pediatrician and expert cardiologist. A Mindray DC-N6 Sonography system echocardiogram machine was used.
Results: A total of 3,00,714 children were screened out of which 541 children had murmur on auscultation. Of these, 306 children (57%) were further diagnosed with either CHD/RHD while remaining 235 children (43%) had a normal study which concluded that they presented with an innocent murmur. CHD was present in 241 (44.5%) children. RHD was diagnosed in 56 (10%) patients. Complex/Critical cardiac lesions were diagnosed in 9 children. . Echocardiography prevalence of RHD was 0.2 /100) and prevalence of CHD was 0.5/1000.
Conclusion: It was concluded that careful cardiac auscultation, as a part of compulsory health screening at primary school entry and exit, will help detect asymptomatic children with heart disease and facilitate treatment before the onset of complications.

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