Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 1 de 1
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
J Am Heart Assoc ; 7(4)2018 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-29444774

RESUMO

BACKGROUND: Considering the limited accuracy of clinical examination for early diagnosis of rheumatic heart disease (RHD), echocardiography has emerged as an important epidemiological tool. The ideal setting for screening is yet to be defined. We aimed to evaluate the prevalence and pattern of latent RHD in schoolchildren (aged 5-18 years) and to compare effectiveness of screening between public schools, private schools, and primary care centers in Minas Gerais, Brazil. METHODS AND RESULTS: The PROVAR (Rheumatic Valve Disease Screening Program) study uses nonexperts and portable and handheld devices for RHD echocardiographic screening, with remote interpretation by telemedicine, according to the 2012 World Heart Federation criteria. Compliance with study consent and prevalence were compared between different screening settings, and variables associated with RHD were analyzed. In 26 months, 12 048 students were screened in 52 public schools (n=10 901), 2 private schools (n=589), and 3 primary care centers (n=558). Median age was 12.9 years, and 55.4% were girls. Overall RHD prevalence was 4.0% borderline (n=486) and 0.5% definite (n=63), with statistically similar rates between public schools (4.6%), private schools (3.5%), and primary care centers (4.8%) (P=0.24). The percentage of informed consents signed was higher in primary care centers (84.4%) and private schools (66.9%) compared with public schools (38.7%) (P<0.001). Prevalence was higher in children ≥12 years (5.3% versus 3.1%; P<0.001) and girls (4.9% versus 4.0%; P=0.02). Only age (odds ratio, 1.12; 95% confidence interval, 1.09-1.17; P<0.001) was independently associated with RHD. CONCLUSIONS: RHD screening in primary care centers seems to achieve higher coverage rates. Prevalence among schoolchildren is significantly high, with rates higher than expected in private schools of high-income areas. These data are important for the formulation of public policies to confront RHD.


Assuntos
Ecocardiografia , Doenças das Valvas Cardíacas/diagnóstico por imagem , Programas de Rastreamento/métodos , Cardiopatia Reumática/diagnóstico por imagem , Adolescente , Distribuição por Idade , Brasil/epidemiologia , Criança , Pesquisa Comparativa da Efetividade , Feminino , Doenças das Valvas Cardíacas/epidemiologia , Humanos , Masculino , Valor Preditivo dos Testes , Prevalência , Atenção Primária à Saúde , Setor Privado , Setor Público , Cardiopatia Reumática/epidemiologia , Serviços de Saúde Escolar
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...