Royal Darwin Hospital, Darwin, NT
Royal Darwin Hospital, Darwin, NT.
Med J Aust. 2018 Apr 16;208(7):303-307. doi: 10.5694/mja17.00666.
To determine the prevalence of rheumatic heart disease (RHD) in school-aged children and young people in Timor-Leste.
Prospective cross-sectional survey. Echocardiography was performed by Australian cardiologists to determine the presence of RHD. Demographic data were also collected. Patients in whom RHD was detected were entered into a register to allow monitoring of adherence to secondary prophylaxis; the first dose of benzathine penicillin G (BPG) was administered on the day of screening.
Schools in urban (Dili) and rural (Ermera) Timor-Leste.
School students aged 5-20 years.
Definite and borderline RHD, as defined by World Heart Federation echocardiographic criteria.
1365 participants were screened; their median age was 11 years (IQR, 9-14 years), and 53% were girls. The estimated prevalence of definite RHD was 18.3 cases per 1000 population (95% CI, 12.3-27.0 per 1000), and of definite or borderline RHD 35.2 per 1000 (95% CI, 26.5-46.4 per 1000). Definite (adjusted odds ratio [aOR], 3.5; 95% CI, 1.3-9.4) and definite or borderline RHD (aOR, 2.7; 95% CI, 1.4-5.2) were more prevalent among girls than boys. Eleven children (0.8%) had congenital heart disease. Of the 25 children in whom definite RHD was identified, 21 (84%) received education and a first dose of BPG on the day of screening; all 25 have since received education about primary care for RHD and have commenced penicillin prophylaxis.
The rates of RHD in Timor-Leste are among the highest in the world, and prevalence is higher among girls than boys. Community engagement is essential for ensuring follow-up and the effective delivery of secondary prophylaxis.
确定东帝汶学龄儿童和青少年风湿性心脏病（RHD）的患病率。
前瞻性横断面调查。澳大利亚心脏病专家进行超声心动图检查以确定 RHD 的存在。还收集了人口统计学数据。发现 RHD 的患者被纳入登记册，以监测对二级预防的依从性；在筛查当天给予苄星青霉素 G（BPG）的第一剂。
东帝汶城市（帝力）和农村（埃梅拉）的学校。
年龄在 5-20 岁的在校学生。
共筛查了 1365 名参与者；他们的中位年龄为 11 岁（IQR，9-14 岁），53%为女孩。明确 RHD 的估计患病率为每 1000 人 18.3 例（95%CI，每 1000 人 12.3-27.0 例），明确或边界 RHD 为每 1000 人 35.2 例（95%CI，每 1000 人 26.5-46.4 例）。明确 RHD（调整后的优势比[aOR]，3.5；95%CI，1.3-9.4）和明确或边界 RHD（aOR，2.7；95%CI，1.4-5.2）在女孩中比男孩更常见。有 11 名儿童（0.8%）患有先天性心脏病。在 25 名被诊断为明确 RHD 的儿童中，有 21 名（84%）在筛查当天接受了教育和第一剂 BPG；自那以后，所有 25 名儿童都接受了关于 RHD 初级保健的教育，并开始接受青霉素预防。
东帝汶的 RHD 发病率是世界上最高的，女孩的发病率高于男孩。社区参与对于确保后续治疗和有效实施二级预防至关重要。
