Abstract

*Dr. Muhammad Ammar Ajmal, Dr. Hira Ahmad and Dr. Hina Shahid

ABSTRACT

Objective: To assess the unrevealed prevalence, Clinical and Echocardiography features of patients with (RF/RHD) in rural population.2) To highlight the importance of nationwide preventive measure to combat the challenge. Methods: Cross sectional survev of 11 villages having multiethnic composition were carried out using the scientific sampling techniques and screening methodology. Proven RHD patients were evaluated by history, detailed physical examination and Lab. tests including ECG, chest X-rav, Echo/Doppler studies. Results: Mean age was 31±18.38 years SD, with 35% of 20 years or less. Females had significant preponderance. More than half were in NYHA class Il. Newly detected were 81%. The commonest symptom was dysponea. History suggestive of RF was elicited in 56%. Patients with RI-ID but unaware of RF[Endocarditis prophylaxis were 92%. 87% of RF/RHD disease continues to be a major scourge in developing counffies like Pakistan.[I] The all RI-ID cases had either mild or moderate valvular deformity. The commonest lesion was combined mitral and aortic valve disease. The most frequent, isolated valvular lesion was mitral stenosis (MS). Juvenile MS was present in 15%. Conclusion: In our survey, we found a large reservoir of teenage patients, one third < 20 years with RHD/RF. Newly detected 80% asymptomatic patients, were unaware of their disease. Additionally (92%) were ignorant about rheumatic prophylaxis. This highlights alarming facts about the concealed prevalence of RHD and ignorance among the public about their disease. It justifies nationwide emergency community oriented preventive measures and public awareness campaigns, to fight this crippling disease of the youngsters. clinical manifestations of RF / RHD has been reported in various studies based on hospital data.[2,3,4] Hospitalized patients are usually sick and have advanced RHD. As such, they do not represent the true disease prevalence of the community. To unreveal the concealed disease burden and clinical spectrum, door to door search is mandatory, to identify patients in communities through cross sectional survey.