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\begin{document}

\title{Prevalence and follow-up of subclinical rheumatic heart disease amongst
asymptomatic school children in a north-western district of India based
on the World Heart Federation echocardiographic criteria}



\author[1]{Dinesh Choudhary}%
\author[2]{Sadik Panwar}%
\author[1]{Balkishan Gupta}%
\author[3]{Raja Panwar}%
\author[4]{Rajeev Gupta}%
\author[1]{Maneesha Bhaya}%
\author[5]{Rajesh Beniwal}%
\author[3]{Arvind Sharma}%
\author[6]{Vasim Panwar}%
\author[7]{Navin Nanda}%
\affil[1]{Sardar Patel Medical College}%
\affil[2]{beckley arh }%
\affil[3]{Rajasthan University of Health Sciences}%
\affil[4]{Eternal Heart Care Centre and Research Institute}%
\affil[5]{Calendula Healthcare Ltd}%
\affil[6]{Rajasthan Dental College and Hospital}%
\affil[7]{University of Alabama at Birmingham}%


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  \date{May 23, 2024}


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\begin{abstract}
Background Past active surveillance have reported prevalence of
subclinical RHD amongst school children which are not comparable because
of major differences in screening methods. The present study is based on
the WHF criteria to assess the prevalence of subclinical carditis due to
RHD and elucidate evolution of the disease when these children were
placed on appropriate antibiotic prophylaxis and regular follow-up. This
is the first large active surveillance study which has been conducted in
a single district of India after the publication of WHF criteria and is
reporting short-medium term follow-up data. Methods For active
surveillance of RHD among urban and rural school children of Bikaner, a
random inclusion strategy was adopted. The diagnostic labelling based on
the echocardiographic criteria proposed by World Heart Federation was
done by a group of experienced cardiologists. The follow up of the
patients recruited in to the study was done to ascertain the early
evolution of the disease in the presence of appropriate antibiotic
prophylaxis. Results A high prevalence of subclinical RHD was noted in
the study population. Pathological mitral and/or aortic valves
regurgitation was the commonest lesion and significant proportion of
cases improved on regular antibiotic prophylaxis. There was no case of
fixity of leaflets/ stenosis. Conclusion The prevalence of subclinical
RHD and these cases are reversible if appropriate antibiotic prophylaxis
is instituted at an early stage.%
\end{abstract}%



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