Handheld echocardiography for screening and control of rheumatic heart disease study in Gezira state, Sudan: a double approach model

Rheumatic heart disease (RHD) is a devastating complication of acute rheumatic fever (ARF), a preventable sequelae of group A beta-hemolytic streptococcal infection in young people living in underdeveloped countries. RHD is considered the most common cause of heart disease in people less than 25 years in Sudan and worldwide (1,2). In referral centers, it was noted that the majority of RHD patients come from certain states including Kordofan, Darfur, White Nile, Gezira and Sennar (3). A program for control of RHD was established in 2012 through collaboration between Sudan Heart Society and Federal Ministry of Health with the main objectives of surveillance, training and public awareness (3,4). An echocardiographic (echo) screening program was established in 2015, results from South Darfur and Khartoum showed a wide disparity in echo prevalence; 19/1,000 in Darfur and 0.3/1,000 in Khartoum (5). In Kordofan, west of Sudan a strikingly high echo prevalence of 61/1,000 was documented which correlated with the findings of the hospital registry where most patients came from Kordofan area (6). More echo screening programs are needed in order to map the prevalence of RHD in other states and consequently establish control programs in high burden areas. This study was carried in order to measure the echo prevalence and start a control program in Gezira state, central Sudan