[Rheumatic heart disease in schoolchildren in Brazzaville]. / Les Cardiopathies rhumatismales en milieu scolaire à Brazzaville.

The purpose of this study is to screen for rheumatic heart disease as a basis for treatment of the disease and determination of its prevalence in schoolchildren in Brazzaville, Congo. Surveying was conducted in 4 schools located in suburban districts of Brazzaville from May to June 2005. A cohort of 2250 school children was enrolled by random sampling at 3 levels. Age ranged from 5 to 17 years. The variables recorded were age, sex, socioeconomic status, clinical features, and laboratory findings. Clinical selection was based on cardiac auscultation. Data analysis was performed using the Epi Data 3.1 and Stata 8.2 software packages (differences being considered as significant at p< 0.05). A total of 2232 children underwent testing including 1900 from public schools (boys, 47.5%; girls, 52.5%) and 332 from private schools (boys, 47.3%; girls, 52.7%) (p>0.05). The prevalence of rheumatic heart disease was 3,5 per thousand overall, 3.6 per thousand in children in the low socioeconomic status group, and 3 per thousand in the high socioeconomic status group (p<0.05). The ages of children presenting valvular cardiopathy ranged from 7 and 16-years-old and 75% lived in overcrowded dwellings. One or more previous episodes of strep throat were noted in all cases and had not been treated in 7 out of 8 cases. Valvular disease was significantly correlated with history of strep throat, overcrowded living conditions, and low socioeconomic status (p<0,01). Compliance with prophylactic treatment using benzathyn penicillin was 75% after one month of follow-up and 37.5% after three months.

Les cardiopathies rhumatismales en milieu scolaire a Brazzaville

L'objectif de l'etude est de determiner la prevalence des cardiopathies rhumatismales en milieu scolaire a Brazzaville; Congo; et traiter les cas ainsi depistes. Une enquete de prevalence a ete realisee dans 4 ecoles des quartiers suburbains de Brazzaville. L'etude s'est deroulee aux mois de mai et juin de l'annee 2005. Le sondage etait aleatoire a trois niveaux aupres d'un echantillon de 2250 ecoliers. L'age etait compris entre 5 et 17 ans. Les variables etudiees etaient : l'age; le sexe; le statut socio-economique; les aspects cliniques et para cliniques. La selection clinique etait basee sur l'auscultation cardiaque. Les logiciels Epi Data 3.1 et Stata 8.2; ont permis la saisie et l'analyse des donnees (difference significative pour p0;05). Le nombre d'enquetes etait de 2232. Il y avait 1900 enfants issus des ecoles publiques (47;5de garcons; 52;5de filles); 332 issus de l'ecole privee (47;3de garcons; 52;7de filles) p0; 05. La prevalence clinique des cardiopathies rhumatismales etait de 3;5(3;6chez les ecoliers de classe sociale basse et 3chez ceux de haut statut socio-economique; p0;05). L'age des enfants presentant des cardiopathies valvulaires etait compris entre 7 et 16 ans; 75d'entre eux vivaient dans des habitations surpeuplees. Un ou plusieurs antecedents d'angines etaient retrouves dans tous les cas; non traitees dans 7 cas sur 8. Il y avait une relation entre les antecedents d'angines; la promiscuite; et le statut socio-economique (p0;01). La compliance au traitement prophylactique par la benzathine penicilline etait de 75au 1er mois du suivi; et seulement de 37;5au 3e