Observational studyJMIR public health and surveillance2026
Prevalence of Early Rheumatic Heart Disease Among Asymptomatic Students in Underserved Communities in Ethiopia: Cross-Sectional Observational Study.
Observational study in JMIR public health and surveillance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Electrocardiographic Digital Biomarkers in Asymptomatic Schoolchildren with Rheumatic Heart Disease.Pediatric cardiology · 2026Article
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12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundRheumatic heart disease (RHD) is a sequela of recurrent, untreated group A Streptococcus infections. RHD disproportionately affects children and young adults in the Global South. Intermittent mass screening of early RHD by using affordable tools in these disease-endemic regions is essential for effective prevention.
objectiveThis study examined multimodal physiological data for assessing the prevalence of early RHD in a cohort of asymptomatic, at-risk students in rural Ethiopia.
methodsA total of 584 asymptomatic children aged 10 to 20 years were randomly selected for screening and stratified into 2 groups (≤14 and >14 years). Electrocardiogram, phonocardiogram, and echocardiography screening were performed, with diagnoses based on the 2012 World Heart Federation criteria.
resultsAfter excluding 1.4% (8/584) of the children, who had nonrheumatic findings, 576 participants were analyzed, including 334 (58.0%) female and 242 (42.0%) male children. The mean age was 16.1 (SD 2.4) years (95% CI 15.9-16.3). Echocardiographic screening identified 19 cases of RHD (n=10, 52.6% borderline and n=9, 47.4% definite). Female children accounted for 68.4% (13/19) of cases, and the association between female sex and RHD was not statistically significant (odds ratio 1.59, 95% CI 0.60-4.25; P=.35). The estimated prevalence of RHD was 32.5 per 1000 population (95% CI 18.1-46.9; SE 7.4; 19/576, 3.3%), which was significantly higher than the most recent multicenter prevalence estimate of 19 per 1000 population (95% CI 13.9-23.4; odds ratio 2.12; P=.03). Mitral regurgitation was the predominant lesion (16/19, 84.2%), followed by mitral stenosis (2/19, 10.5%) and aortic regurgitation (1/19, 5.3%). Phonocardiogram analysis showed mitral regurgitation (10/19, 52.6%), mitral stenosis (2/19, 10.5%), and subclinical findings in the rest of patients with RHD. Prolonged PR intervals were observed in 10.5% (2/19) of the RHD-positive participants.
conclusionsThis study confirms persistent high prevalence of asymptomatic RHD among students in rural regions of Ethiopia. Although there was a female predominance in RHD incidence, the difference between the sexes was not statistically significant.
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