Objective: To determine the prevalence of rheumatic heart disease (RHD), and the impact of potential risk factors on its occurrence among school children in Addis Ababa.
Design: Cross-sectional survey of school children for the presence or absence of RHD.
Setting: Randomly selected ten government and five private schools from the list of all government and private schools in Addis Ababa teaching grades 7 and 8.
Subjects: All school children attending grades 7 and 8 in the randomly selected schools.
Main outcome measures: Clinical findings suggestive of RHD confirmed by echocardiographic and Doppler studies.
Results: Out of the 10,053 school children selected for the study 9,388 (93%) were examined. Sixty of the 9,388 school children examined were subsequently confirmed to have RHD giving an overall prevalence rate of 6.4 per 1000 children. The prevalence for government and private schools representing low and high socio-economic groups were 7.1 and 1 per 1000 children respectively (Fisher's exact = 0.019). Crowding conditions at home, in schools and in the bedrooms were not associated with the risk of RHD (chi 2 = 4.968; p > or = 0.174).
Conclusion: This study confirmed that the prevalence of RHD, at least in the low socio-economic group is among the highest in the world. This evidence highlights the need for an urgent control programme.