Prevalence of rheumatic heart disease among school children in Addis Ababa

Objective: To determine the prevalence of rheumatic heart disease (RHD), an d the impact of potential risk factors on its occurrence among school child ren in Addis Ababa. Design: Cross-sectional survey of school children for the presence or absen ce of RHD. Setting: Randomly selected ten government and five private schools from the list of all government and private schools in Addis Ababa teaching grades 7 and 8. Subjects: All school children attending grades 7 and 8 in the rand omly selected schools. Main outcome measures: Clinical findings suggestive of RHD confirmed by ech ocardiographic and Doppler studies, Results: Out of the 10,053 school children selected for the study 9,388 (93 %) were examined. Sixty of the 9,388 school children examined were subsequ ently confirmed to have RHD giving an overall prevalence rate of 6.4 per 10 00 children. The prevalence for government and private schools representing low and high socio-economic groups were 7.1 and 1 per 1000 children respec tively (Fisher's exact = 0.019), Crowding conditions at home, in schools an d in the bedrooms were not associated with the risk of RHD (chi 2 = 4.968; p greater than or equal to 0.174), Conclusion: This study confirmed that the prevalence of RHD, at least in th e low socioeconomic group is among the highest in the world. This evidence highlights the need for an urgent control programme.