Cardiovascular Journal of Africa: Vol 29 No 5 (September/October 2018)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 5, September/October 2018 AFRICA 277
that morphological criteria diagnosed by HHE had poor
sensitivity for definite RHD, therefore these parameters should
be interpreted with caution when diagnosed with HHE.
A prevention programme for RHD was initiated in South
Darfur using scanty resources. Training and raising the awareness
of a large number of health workers can be achieved. A regional
register for RHD as well as an echo clinic were established, which
serves South Darfur and nearby states.
There were some limitations to this study. Electricity was not
available in most of the schools so we had to use generators. In
Darfur, the generator electricity was unstable and the chargers
of the V scans were damaged, which led to a premature ending
of the study. When asked to come for the SE, many families
were not available, but we are in contact with those who did not
attend as we realise that there are probably many cases of RHD
among them. Lastly, the roads to the camps were not paved in
an area experiencing heavy rains, which led to the cancellation
of many trips.
Conclusion
RHD prevalence in Khartoum has dropped significantly in the
last 23 years. However we found a high prevalence of RHD
in Niyala, Darfur camps, reflecting the vulnerability of this
community. HHE using a single view was reliable and performed
well in screening for RHD. We initiated a control programme
despite limited resources, which needs to be consolidated in this
area and in similarly affected rural Sudanese communities.
In order to have an impact on clinical practice, mapping
of RHD cases within the country must be carried out. HHE
screening is a cheap and fast tool to identify hot spots of RHDand
this study will be replicated in other areas. Control programmes
must be implemented in high-prevalence areas. The reliability of
HHE obviates the need to do an SE, therefore definite cases can
immediately be started on penicillin prophylaxis.
Two HHE machine V scans were donated by the Sudanese American Medical
Association ), which obtained special permission
from the United States government to purchase General Electric V scans for
use in Sudan. Special thanks go to Drs Ameena Adam and Kawther Yusuf,
who conducted the echo screening in Niyala. The study was funded by a
Ministry of Higher Education research grant. The funders had no role in the
execution, analysis or writing of this study.
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