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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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Main Authors: Zahari, Norazah, Yeoh, Si Ling, Muniandy, Siva Rao, Bah, Mohd Nizam Mat
Format: Article
Published: Oxford Univ Press 2022
Subjects:
RJ Pediatrics
RV Botanic, Thomsonian, and eclectic medicine
Online Access:http://eprints.um.edu.my/33494/
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spelling 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
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic RJ Pediatrics
RV Botanic, Thomsonian, and eclectic medicine
spellingShingle 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
description 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/
_version_ 1740826036095942656
score 13.211869

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