Prevalence of Structural Heart Diseases Detected by Hand-Held Echocardiographic Device in School-Age Children in Iran: A Cross-Sectional Study

Abstract

Background: Structural heart disease (SHD) has great impacts on healthcare systems, creating further public health concerns. Proper data are scant regarding the magnitude of the affected population by SHD. We aimed to determine the prevalence of SHD among children and adolescents. Methods: In this population-based study, multistage cluster-random sampling was used to choose schools from the Tehran urban area. All students were examined using a handheld Vscan device by echocardiographer, and the results were concurrently supervised and interpreted by cardiologists. All the major findings were reevaluated in hospital clinics. Findings: Of 15130 students (6-18 years, 52.2% boys) who were examined, the prevalence of individuals with congenital heart disease (CHD) and cardiomyopathy was 152 (10.04 per 1000 persons) and 9 (0.6 per 1000 persons), respectively. The prevalence of definite and borderline rheumatic heart disease (RHD) was 30 (2 per 1000 persons) and 113 (7.5 per 1000 persons), correspondingly. Non-rheumatic valvular heart disease (VHD) was also detected in 465 (30.7 per 1000 persons) students. Of all the pathologies, only 39 (25.6%) cases with CHD and 1 (0.007%) cases with RHD had already been diagnosed. Parental consanguinity was the strongest predictor of CHD and SHD (odds ratio [OR]: 1.907, 95% CI: 1.358 to 2.680; P < 0.001 and OR: 1.855, 95% CI: 1.334 to 2.579; P <0.001, respectively). The female sex (OR: 1.262, 95% CI: 1.013 to 1.573; P = 0.038) and fathers’ low literacy (OR: 1.872, 95% CI: 1.068 to 3.281; P = 0.029) were the strongest predictors of non-rheumatic VHD and RHD, correspondingly. Interpretation: The implementation of handheld echocardiographic screening for detecting SHD among young population is feasible and efficacious which detected SHD prevalence in our population comparable to previous reports. Further studies are required to delineate its economic aspects for community-based screening. Funding Information: National Institute for Medical Research Development. Declaration of Interests: SH reports grants from the National Institute for Medical Research Development (NIMAD), during the conduct of the study. All other authors have none to declare. Ethics Approval Statement: The study complies with the Declaration of Helsinki, and the 8 study protocol was evaluated and approved by the Ethics Committee of the National Committee for Ethics in Biomedical Research.