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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 5, September/October 2017
288
AFRICA
The mean age of the 17 subjects found to have RHD was 12.2
years, which was slightly greater than the mean age (11.2 years)
of the 2 501 evaluated group. This discrepancy in ages was not
statistically significant. In fact, among the group of previously
described older children, there was also a higher prevalence of
RHD when compared with the younger age group. However,
these age differences were not statistically significant (
p
=
0.856).
Mean weight and height for these 17 subjects were 35.68 kg
(78.5 lbs) and 139.88 cm (55.1 inches), respectively. Forty-nine
per cent were male and 51% were female. While there was a
higher prevalence of echocardiographic valvular findings in the
Table 2. Summary of echocardiographic findings among the
17 subjects found to have rheumatic valvular heart disease
WHF category
Valve lesion Male Female Total Percentage
Subjects with RHD
using WHF criteria
17
13
4
17
0.68
Borderline
Pathological MR 10
3
13
0.52
Pathological AR 0
0
Definite
Pathological MR 2
1
4
0.16
Pathological AR 1
0
For complete 2012 WHF diagnostic criteria in children (and adults), refer to
reference 10.
MV morphological features
AV morphological features
1. AMVL
≥
3mm
n
=
3
2. Chordal thickening
n
=
1
3. Restricted leaflet motion
n
=
0
4. Excessive AMVL
n
=
1
1. Irregular or focal thickening
n
=
0
2. Coaptation defect
n
=
0
3. Restricted leaflet motion
n
=
0
4. Leaflet prolapse
n
=
1
1. Colour jet length
=
≥
2 cm
n
=
13
2. Seen in 2 views
n
=
13
3. Velocity
≥
3 m/s
n
=
13
4. Pansystolic
n
=
13
1. Colour jet
=
≥
1 cm
n
=
0
2. Seen in 2 views
n
=
0
3. Velocity
≥
3 m/s
n
=
0
4. Pansystolic
n
=
0
Pathological MR:
Doppler measures
Pathological AR:
Doppler features
n
=
4
n
=
0
n
=
13
n
=
0
Borderline cases (
n
=
13)
1. AMVL
≥
3mm
n
=
3
2. Chordal thickening
n
=
3
3. Restricted leaflet motion
n
=
3
4. Excessive AMVL
n
=
0
1. Irregular or focal thickening
n
=
1
2. Coaptation defect
n
=
1
3. Restricted leaflet motion
n
=
0
4. Leaflet prolapse
n
=
0
1. Colour jet length
=
≥
2 cm
n
=
3
2. Seen in 2 views
n
=
3
3. Velocity
≥
3 m/s
n
=
3
4. Pansystolic
n
=
3
1. Colour jet
=
≥
1 cm
n
=
1
2. Seen in 2 views
n
=
1
3. Velocity
≥
3 m/s
n
=
1
4. Pansystolic
n
=
1
n
=
3
n
=
1
n
=
3
n
=
1
Definite cases (
n
=
4)
Fig. 4.
Children assessed as definite or borderline RHD using the morphological and Doppler criteria for RHD according to the
WHF 2012 criteria.
9
Age
6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Percentage
14
12
10
8
6
4
2
0
2.3
6.8
9.8
9.3
11.7
8.9
10.1
11.6
12.0
10.2
4.6
1.6
0.7
0.3 0.1
Fig. 2.
Age distribution of the 2 501 Rwandan school children
studied echocardiographically.
Age
8 9 10 11 12 13 14 15 16 17 18
Percentage
30
25
20
15
10
5
0
11.8
5.9
11.8
17.7
23.5 23.5
5.9
Fig. 3.
Age distribution of the 17 subjects diagnosed with
rheumatic valvar heart disease using the WHF 2012
echocardiographic criteria.
9