Zaman M Mostafa, Choudhury Sohel Reza, Rahman Shafiqur, Ahmed Jasimuddin
World Health Organization, Dhaka, Bangladesh.
National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh.
Indian Heart J. 2015 Jan-Feb;67(1):45-9. doi: 10.1016/j.ihj.2015.02.009. Epub 2015 Feb 26.
Recent prevalence data on rheumatic fever (RF) and rheumatic heart disease (RHD) are lacking in Bangladeshi population.
We have done this national level cross-sectional survey to determine the prevalence of RF and RHD in Bangladeshi children.
Samples were drawn from three out of seven divisions of Bangladesh from both urban and rural areas. Trained and experienced enumerators visited households to suspect cases of RF or RHD in 5-19 years children by asking structured questions on symptoms and signs of RF and RHD (n = 56,827). Then trained doctors again took history and examined them for RF/RHD. RF was defined according to the Modified Jones Criteria 1992. Doppler echocardiography was done to confirm the diagnosis in all suspected cases of RF/RHD.
A total of 36 RF cases (new and old) and 16 Doppler echocardiography confirmed RHD cases were identified. Prevalence of RF and RHD was 0.9 per 1000 (95% confidence interval: 0.7-1.2) while prevalence of RF was 0.6 per 1000 (95% CI: 0.4-0.9) and RHD 0.3 per 1000 (95% CI: 0.2-0.5).
Observed prevalence of RF and RHD indicates that RF/RHD is disappearing from Bangladesh. However, studies using new technology of portable echocardiographic screening are needed.
孟加拉国人群缺乏近期风湿热（RF）和风湿性心脏病（RHD）的患病率数据。
我们开展了这项全国性横断面调查，以确定孟加拉国儿童中RF和RHD的患病率。
从孟加拉国七个行政区中的三个行政区的城乡地区抽取样本。训练有素且经验丰富的调查员通过询问有关RF和RHD症状和体征的结构化问题，走访家庭以排查5至19岁儿童中的RF或RHD病例（n = 56,827）。然后，训练有素的医生再次询问病史并对他们进行RF/RHD检查。RF根据1992年修订的琼斯标准进行定义。对所有疑似RF/RHD病例均进行了多普勒超声心动图检查以确诊。
共识别出36例RF病例（新病例和旧病例）以及16例经多普勒超声心动图确诊的RHD病例。RF和RHD的患病率为每1000人中有0.9例（95%置信区间：0.7 - 1.2），而RF的患病率为每1000人中有0.6例（95%CI：0.4 - 0.9），RHD为每1000人中有0.3例（95%CI：0.2 - 0.5）。
观察到的RF和RHD患病率表明RF/RHD正在从孟加拉国消失。然而，需要开展使用便携式超声心动图筛查新技术的研究。
