Abstract

*Guantama Khadka, Paras Buddha and Bhanubhakta Sherpa

To determine the prevalence of rheumatic heart disease (RHD) and congenital heart disease (CHD) among school children in Chitwan district using clinical and echocardiographic criteria. This is a cross-sectional study involving 7650 school children from general schools (4100) and private boarding schools (3550). The selected students were clinically examined in the school and those having cardiac murmurs were assessed in the hospital (College of Medical Sciences-Teaching Hospital, Bharatpur) by trained cardiologists with transthoracic two dimensional echocardiography along with colour doppler. Agespecific rates (prevalence/thousand) of murmurs and structural heart disease (RHD and CHD) were determined. The age of the students ranged from 4 to 15 years with girls preponderance (Girl: Boy = 1.18:1). A significant cardiac murmur was observed in 345 students (45.00/1000) with similar prevalence in boys (45.71) and girls (44.58). Definite RHD was detected in 12 students (1.57/1000) and CHD in 30 patients (3.92/1000). The dominant rheumatic cardiac lesions were mitral regurgitation (3 in number) followed by mitral stenosis (2 in number) and aortic regurgitation (2 in number). Commonest CHD demonstrated were mitral valve prolapse (14 in number) followed by bicuspid aortic valve (9 in number), a trial septum defectostium secundum (3 in number), ventricular septal defect (2 in number) and severe pulmonary stenosis (2 in number). There is a low prevalence of RHD and CHD in school children in this region of central Nepal compared to previous Nepalese studies. Cardiac murmurs and RHD are more prevalent among low SES children in general school.