The Society for Heart Valve Disease

 

 

Prevalence of Rheumatic Heart Disease in Yemen

enrico donegani.
Maggiore della Carit´┐Ż University Hospital, Novara, Italy.


Objective
Yemen, an underdeveloped country, still suffers from many diseases that have become history in developed countries. Worldwide, rheumatic heart disease (RHD) results in around 300.000 deaths each year, with two million people requiring repeated hospitalizations and one million likely will require surgery 5 to 20 years after the fever’s occurrence, and mostly affects young people where poverty is widespread.
The main aim of this epidemiological study was to obtain baseline data on the extent and distribution of RHD in Yemen, among schoolchildren population.
Methods
A sample of 5000 schoolchildren was screened from 50 of the 223 government schools in Yemen. Screening was carried out by cardiac examination of every child. All cases of suspected RHD, on the basis of a murmur on auscultation, underwent electrocardiography, chest radiography and Doppler echocardiographic examination. Confirmation was based on the modified Jones Criteria and evidence of valvular deformity by echocardiography
Results
Among the screened students, 49.9% were males. The highest number of cases was found between 8 and 15 years, mean age 11.28 years, significantly more prevalent in girls (58%). Valvular lesions were mainly pure mitral regurgitation (44%), combined aortic and mitral valve disease (27%) and mitral stenosis in 17%. The prevalence in schoolchildren was 3.6 per 1000, higher than many other countries, especially neighbouring ones. Reports from Oman indicate a rate of 0.8 per 1000 and the prevalence in Saudi Arabia is 2.8 per 1000.
Conclusions
There is a significant correlation between socioeconomic level and the prevalence of RHD in Yemen, the high prevalence being attributed largely to a low standard of living.
Yemen is now in the state of epidemiological transition, having the double burden placed upon its health care system of both infection diseases and emerging non-communicable cardiovascular diseases. As in most developing countries, RHD has it place in everyday practice in Yemen.
Because of the sensitive nature of cardiac disease and lack of facilities to embrace as many of the daily-increasing cardiac patients as possible, the Yemeni Government decided to build the Cardiac Center of the General Military Hospital, inaugurated in December 2010 and dedicated for cardiac surgery.
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