Rheumatic heart disease in Timor-Leste school students: an echocardiography-based prevalence study

Area of Science:

• Cardiology
• Public Health
• Pediatrics

Background:

• Rheumatic heart disease (RHD) poses a significant global health burden, particularly in low-resource settings.
• Understanding the prevalence and risk factors of RHD in specific populations is critical for targeted interventions.

Purpose of the Study:

• To determine the prevalence of rheumatic heart disease (RHD) among school-aged children and young people in Timor-Leste.
• To identify potential disparities in RHD prevalence based on sex.

Main Methods:

• A prospective cross-sectional survey was conducted in urban and rural schools in Timor-Leste.
• Echocardiography was used to diagnose definite and borderline RHD in 1365 students aged 5-20 years.
• Demographic data were collected, and RHD patients were registered for monitoring of secondary prophylaxis with benzathine penicillin G (BPG).

Main Results:

• The prevalence of definite RHD was 18.3 per 1000, and definite or borderline RHD was 35.2 per 1000.
• RHD was significantly more prevalent in girls than boys (aOR 3.5 for definite RHD, aOR 2.7 for definite or borderline RHD).
• Of 25 children with definite RHD, 84% received initial BPG and education on screening day, with all commencing penicillin prophylaxis.

Conclusions:

• Timor-Leste exhibits some of the highest RHD rates globally, with a notable higher prevalence in girls.
• Effective community engagement is vital for successful follow-up and delivery of secondary prophylaxis to combat RHD.