Preventive and clinical aspects of cardiac problems among school children in Alexandria

ABSTRACT

A retrospective study of cardiac problems among school children in Alexandria has been done to determine some aspects of the pattern of the problem and to assess the secondary prophylaxis and follow-up measures. Of the 398 cases [mean age of 12.1 +/- 2.2 years] registered in the cardiac clinic of the student hospital in the city, 258 children [64.8%] were rheumatic heart disease [RHD] cases, while 51 children [12.8%] were congenital heart disease [CHD]. Other cases were rheumatic arthritis [13.8%], rheumatic chorea [5.0%], rheumatic fever [1./5%], and functional murmur [2.1%]. Mitral insufficiency was the major functional defect in RHD children [48%], while the ventricular septal defect [VSD] was the main lesion among CHD children [48%]. Within the last year of follow up, the RHD children experienced drop-out rate of secondary penicillin prophylaxis of 28.6% mainly due to parental ignorance [14.6%] and fear of penicillin injection [10.9%], while the recurrence rate of rheumatic fever among them was 29.4%, which increased significantly [P <0.01] to 48.6% among the dropout cases. Non-participation in school physical education was evident among 72.2% and 80% of RHD and CHD children, mainly due to the doctor's certificate and parental over-protection. It was concluded that rheumatic heart disease is the most common cause of heart diseases among school children in the city, and the drop-out of penicillin prophylaxis relatively high. A plan was recommended to improve secondary penicillin prophylaxis and participation in physical education by such group