Screening 150 migrants aged 5-26 found a 6.7% RHD prevalence, highest at 9.9% in Africans, mostly mitral valve insufficiency, indicating subclinical RHD in high-income countries.
What is the prevalence of subclinical rheumatic heart disease detected by screening in young migrant populations from endemic countries in Germany?
A pilot screening study identified a 6.7% prevalence of subclinical rheumatic heart disease among young migrants from endemic countries in Germany, highlighting the potential need for targeted screening programs.
Absolute Event Rate: 0% vs 0%
Abstract Background Rheumatic heart disease (RHD) remains the most commonly acquired heart disease in people under the age of 25. The economic cost of RHD is significant, because its most devastating effects are on young adults in their most productive years. With a rise in migration of people from RHD endemic countries, it is plausible that RHD may have a "silent" resurgence in Europe where research efforts on this disease have dropped dramatically in recent decades. RHD progression can be prevented through secondary antibiotic prophylaxes. If left untreated it can result in heart failure due to valvular defects. To date, a single study documented a notable burden of the disease within migrant populations in Europe, thus calling for implementing RHD screening. No follow-up study has been conducted and awareness for the necessity of standardized RHD screening is lacking. Purpose We aim to detect subclinical RHD and establish data on the prevalence of RHD in migrant populations. The results are anticipated to guide local health departments towards RHD prevention and management. Methods We conducted a pilot screening study among migrants using the 2023 World Heart Federation criteria. Participants included migrants from RHD endemic countries, aged 5 to 26 years. Medical history, including risk factors like a history of acute rheumatic fever, was garnered from all participants. The project was conducted in cooperation with the local Health Department in a metropolitan German city where the migrants presented to a mandatory health check-up shortly after registration. Ethics approval was obtained. Results We screened 150 individuals, age range 5-26 years (mean 20 years; SD 5.89) and found a screening prevalence of 6.7% within our study population. Disease burden was highest in the African population with a screening prevalence of 9.9%. The median age amongst participants deemed positive was 24 years (SD 2.2). The most common abnormality was a mitral valve insufficiency measuring 2 cm. One participant presented with an aortic regurgitation. One in ten people with a positive screening result reported to have been previously diagnosed with acute rheumatic fever or had someone in the family being diagnosed with acute rheumatic fever. All the positive participants reported to have been living in households with more than one room and access to electricity and water, indicating a higher socioeconomic status. The average number of people living in the household was 5.2. Conclusion The results of our pilot study support the observation that early stages of RHD are present in certain populations in high-income countries and that a scaled-up comprehensive prevalence study is needed to accurately assess the burden of this disease within our population. Our results indicate that prioritizing RHD screening in high-risk populations in countries no longer considered endemic is warranted to improve RHD prevention and management.
Steinmaurer et al. (Sat,) reported a other. Screening 150 migrants aged 5-26 found a 6.7% RHD prevalence, highest at 9.9% in Africans, mostly mitral valve insufficiency, indicating subclinical RHD in high-income countries.