Shrestha, et al., (2012) in their study “Rheumatic Heart Disease: Pilot Study For a Population-Based Evaluation of Prevalence and Cardiovascular Outcomes among Schoolchildren in Nepal,” established that Rheumatic Heart Disease (RHD) is approximated to affect at least 15 million persons throughout the world (Shrestha, et al., 2012). Each year it leads to an average death of 250 000 people and at least 80 percent of the children below the age of 15 years grow and develop in areas where RHD is prevalent. An inconsistency of reported endemic rates of RHD among school kids in industrializing nations is specifically due to a range of sensitivities of echocardiographic as well as clinical screening.
Education/Anticipatory Guidance Provided to the Parent/Caregiver on Long-term Side Effects and Impacts on Child’s Life
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First, clinical as well as an echocardiographic screening of rheumatic heart disease is possible within 5 to 10 minutes for every child (Shrestha, et al., 2012). Active involvement of the parent or caregiver who is familiar with the child should, therefore, facilitate the organization and expect distrust towards medical specialist from both the child and caregiver. In addition, sufficient collaboration with and orientation of the parent and caregiver after diagnosis of RHD in children is of great significance from observance to preventive antibiotic therapy.
Agreeing to the subclinical rheumatic heart disease diagnosis in a seemingly healthy child is challenging for both the parent and the child, thus requires constant support. Further, collaboration with the family physician and the pediatrician is essential to advance observance to secondary prevention for RHD that is clinically silent. Unreliable data results in insecurity while decreasing the motivation for adherence to consistent antibiotic prevention. Last, the criteria for WHF are helpful tools to categorize subclinical valvular lesions consistent with rheumatic heart disease (Shrestha, et al., 2012).
Long term Impact of RHD
RHD merges a spectrum of various phases of both clinically quiet and apparent valvular deterioration leading to congestive heart failure. Thus, it increases the vulnerability of endocarditis and cerebrovascular events resulting in premature death. It is recommended that partnership with parents/caregivers and family pediatrician or physician is essential to conduct effective screening, increase compliance with subordinate prevention as well as ensure clinical follow-up.
References
Shrestha, R. N., Kalesan, B., Karki, P., Sherpa, K., Basnet, A., Urban, P., et al. (2012). Rheumatic heart disease: pilot study for a population-based evaluation of prevalence and cardiovascular outcomes among schoolchildren in Nepal. BMJ Open, 2, 1-5. doi: 10.1136/bmjopen-2012-001616.
