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Title: Screening for rheumatic heart disease: current approaches and controversies.
Authors: Roberts, Kathryn
Colquhoun, Samantha
Steer, Andrew
Reményi, Bo
Carapetis, Jonathan
Affiliation: Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Rocklands Drive, Casuarina, Darwin, NT 0810, Australia..
Issue Date: Jan-2013
Citation: Nature reviews. Cardiology 2013-01; 10(1): 49-58
Abstract: Rheumatic heart disease (RHD) is a leading cause of cardiac disease among children in developing nations, and in indigenous populations of some industrialized countries. In endemic areas, RHD has long been a target of screening programmes that, historically, have relied on cardiac auscultation. The evolution of portable echocardiographic equipment has changed the face of screening for RHD over the past 5 years, with greatly improved sensitivity. However, concerns have been raised about the specificity of echocardiography, and the interpretation of minor abnormalities poses new challenges. The natural history of RHD in children with subclinical abnormalities detected by echocardiographic screening remains unknown, and long-term follow-up studies are needed to evaluate the significance of detecting these changes at an early stage. For a disease to be deemed suitable for screening from a public health perspective, it needs to fulfil a number of criteria. RHD meets some, but not all, of these criteria. If screening programmes are to identify additional cases of RHD, parallel improvements in the systems that deliver secondary prophylaxis are essential.
DOI: 10.1038/nrcardio.2012.157
Type: Journal Article
Subjects: Adolescent
Child, Preschool
Echocardiography, Doppler, Color
Heart Auscultation
Mass Screening
Predictive Value of Tests
Rheumatic Heart Disease
Diagnostic Imaging
Heart Function Tests
Appears in Collections:NT Health digital library

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