Evidence map›Paper›PMID 29969998›Full record

Observational studyBMC cardiovascular disorders2018

Prevalence of rheumatic heart disease in Zambian school children.

John Musuku, Mark E Engel, Patrick Musonda, Joyce Chipili Lungu, Elizabeth Machila, Sherri Schwaninger, Agnes Mtaja, Evans Mulendele, Dorothy Kavindele, Jonathan Spector and 8 more

Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC cardiovascular disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02661763 (Prevalence of Rheumatic Heart Disease in Zambian Schoolchildren), which is not on this map. Cited by 12 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 4 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02661763 completednot on this map

Prevalence of Rheumatic Heart Disease in Zambian Schoolchildren: an Echocardiographic Screening Study Involving Task-shifting to General Radiographers

TypeobservationalSponsorUniversity of ZambiaRan2015 to 2015Enrolled1,024ConditionsRheumatic Heart Disease
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 4 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Review
  6. Observational
  7. Article
  8. Article
  9. Rheumatic heart disease: current status of diagnosis and therapy.Cardiovascular diagnosis and therapy · 2020
    Review
  10. Article
  11. Article
  12. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 9 institutions in 4 countries.

John MusukuDepartment of Paediatrics & Child Health, University Teaching Hospital, Lusaka, Zambia.
Mark E EngelDepartment of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
Patrick MusondaSchool of Public Health University of Zambia, Lusaka, Zambia.
Joyce Chipili LunguDepartment of Paediatrics & Child Health, University Teaching Hospital, Lusaka, Zambia.
Elizabeth MachilaDepartment of Paediatrics & Child Health, University Teaching Hospital, Lusaka, Zambia.
Sherri SchwaningerGlobal Health, Novartis Institutes for BioMedical Research, Cambridge, MA, USA. sherri.schwaninger@novartis.com.ORCID 0000-0003-4682-1579
Agnes MtajaDepartment of Paediatrics & Child Health, University Teaching Hospital, Lusaka, Zambia.
Evans MulendeleDepartment of Paediatrics & Child Health, University Teaching Hospital, Lusaka, Zambia.
Dorothy KavindeleDepartment of Paediatrics & Child Health, University Teaching Hospital, Lusaka, Zambia.
Jonathan SpectorGlobal Health, Novartis Institutes for BioMedical Research, Cambridge, MA, USA.
Brigitta TadmorNovartis Institutes for BioMedical Research, Cambridge, MA, USA.
Marcelo M GutierrezGlobal Health, Novartis Institutes for BioMedical Research, Basel, Switzerland.
Joris Van DamGlobal Drug Development, Novartis Institutes for BioMedical Research, Cambridge, MA, USA.
Laurence ColinGlobal Drug Development, Novartis Institutes for BioMedical Research, Cambridge, MA, USA.
Aidan LongDepartment of Allergy and Clinical Immunology, Massachusetts General Hospital, Boston, MA, USA.
Mark C FishmanHarvard Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA.
Bongani M MayosiDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Liesl J ZühlkeDepartment of Paediatrics, Red Cross War Memorials Children's Hospital, Cape Town, South Africa.
University Teaching Hospital · ZMCenter for Global Development · USNovartis (Switzerland) · CHUniversity of Cape Town · ZAHarvard University · USMassachusetts General Hospital · USNovartis (United States) · USRed Cross War Memorial Children's Hospital · ZAUniversity of Zambia · ZM

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe large global burden of rheumatic heart disease (RHD) has come to light in recent years following robust epidemiologic studies. As an operational research component of a broad program aimed at primary and secondary prevention of RHD, we sought to determine the current prevalence of RHD in the country's capital, Lusaka, using a modern imaging-based screening methodology. In addition, we wished to evaluate the practicality of training local radiographers in echocardiography screening methods.

methodsEchocardiography was conducted on a random sample of students in 15 schools utilizing a previously validated, abbreviated screening protocol. Through a task-shifting scheme, and in the spirit of capacity-building to enhance local diagnostic and research skills, general radiographers based at Lusaka University Teaching Hospital (UTH) were newly trained to use portable echocardiography devices. Students deemed as screen-positive were referred for comprehensive echocardiography and clinical examination at UTH. Cardiac abnormalities were classified according to standard World Heart Federation criteria.

resultsOf 1102 students that were consented and screened, 53 students were referred for confirmatory echocardiography. Three students had definite RHD, 10 had borderline RHD, 29 were normal, and 11 students were lost to follow-up. The rates of definite, borderline, and total RHD were 2.7 per 1000, 9.1 per 1000, and 11.8 per 1000, respectively. Anterior mitral valve leaflet thickening and chordal thickening were the most common morphological defects. The pairwise kappa test showed fair agreement between the local radiographers and an echocardiographer quality assurance specialist.

conclusionThe prevalence of asymptomatic RHD in urban communities in Zambia is within the range of results reported in other sub-Saharan African countries using the WHF criteria. Task-shifting local radiographers to conduct echocardiography was feasible. The results of this study will be used to inform ongoing efforts in Zambia to control and eventually eliminate RHD.

trial registrationThe study was registered on clinicaltrials.gov ( #NCT02661763 ).

Indexed as

AdolescentAge DistributionChildCross-Sectional StudiesEchocardiographyFemaleHealth SurveysHumansMaleMass ScreeningPredictive Value of TestsPrevalenceReproducibility of ResultsRheumatic Heart DiseaseTime FactorsWorkflowCardiovascular diseaseControl strategiesEchocardiographyEpidemiologyPrevalenceRheumatic feverRheumatic heart diseaseScreeningStreptococcal pharyngitisZambia

Identifiers

PMID29969998
PMCPMC6029054
OpenAlexW2811189477

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.