Rheumatic heart disease in rural south India: A clinico-observational study
Manne Sriharibabu1, Yalamanchali Himabindu, Zubair Kabir
1Department of Medicine, GSL Medical College and General Hospital, N.H 216 Rajahmundry, East Godavari District, Andhra Pradesh 534296, India.
Journal of Cardiovascular Disease Research
|September 12, 2013
Summary
Rheumatic heart disease (RHD) remains a significant public health concern in rural India, with high prevalence observed in younger females. Widespread penicillin prophylaxis is crucial for prevention and reduction of RHD burden.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Rheumatic heart disease (RHD) poses a substantial global health challenge, disproportionately affecting Southeast Asia.
- India accounts for a significant portion of the global RHD burden, with varying prevalence estimates due to diverse methodologies.
- This study addresses the need for precise RHD burden estimation in India using stringent clinical criteria and echocardiography in a rural population.
Purpose of the Study:
- To accurately estimate the prevalence of Rheumatic heart disease (RHD) in a large rural South Indian population.
- To identify clinical complications associated with RHD in this demographic.
- To inform public health strategies for RHD prevention and management in endemic regions.
Main Methods:
- Screened 44,164 eligible patients across 238 primary care centers in rural South India (October 2007 - March 2012).
- Utilized strict clinical criteria and echocardiography for diagnosis.
- Analyzed data from 403 patients aged 15 years and above, including demographic and clinical characteristics, with age standardization.
Main Results:
- The age-standardized RHD prevalence was 9.7 per 1000 population.
- RHD was more prevalent in younger individuals (<44 years) and females.
- Pulmonary hypertension, congestive heart failure (CHF), tricuspid regurgitation, and infective endocarditis were common complications; over two-thirds lacked a history of RHD or penicillin prophylaxis.
Conclusions:
- Rheumatic heart disease (RHD) prevalence remains high in rural Indian populations covered by government health insurance.
- Primary and secondary preventive measures, particularly widespread penicillin prophylaxis, are essential for controlling RHD.
- Urgent implementation of preventive strategies is necessary to reduce the RHD burden in endemic areas like rural India.
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