Child and teacher acceptability of school-based echocardiographic screening for rheumatic heart disease in Uganda

Michelle Ploutz*, Twalib Aliku, Tyler Bradley-Hewitt, Andrea Dantin, Bethan Lemley, Catherine W. Gillespie, Peter Lwabi, Craig Sable, Andrea Beaton

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Introduction Rheumatic heart disease causes substantial morbidity in children in low-income countries. School-based echocardiographic screening has been suggested as a means to identify children with latent disease; however, little is known about the experience of children and teachers participating in screenings. The aim of our study was to assess students' and teachers' experience of school-based echocardiographic screening and identify areas for improvement. Materials and methods A school-based echocardiographic screening programme was conducted in five schools in Northern Uganda in 2013. After 8 months, an age- and gender-stratified population that included 5% of the participating students and teachers completed a questionnaire via an in-person interview. Responses were reviewed by question and coded to identify key themes. Results A total of 255 students (mean 10.7 years; 48% male) and 35 teachers participated in our study. In total, 95% of the students and 100% of the teachers were happy to have participated in the screening; however, students reported feeling scared (35%) and nervous (48%) during the screening process. Programmatic strengths included the following: knowing one's health status, opportunity to receive treatment, and staff interactions. Although 43% of the patients did not suggest a change with open-ended questioning, concerns regarding privacy, fear of the screening process, and a desire to include others in the community were noted. Discussion School-based echocardiographic rheumatic heart disease screening was well received by students and teachers. Future programmes would likely benefit from improved pre-screening education regarding the screening process and diagnosis of rheumatic heart disease. Furthermore, education of teachers and students could improve screening perception and establish realistic expectations regarding the scope of screening.

Original languageEnglish (US)
Pages (from-to)82-89
Number of pages8
JournalCardiology in the young
Volume27
Issue number1
DOIs
StatePublished - Jan 1 2017

Funding

Financial Support This work was supported by the National Institutes of Health National Center for Advancing Translational Sciences (grant numbers UL1TR000- 075 and KL2TR000076). Its contents are the responsibility of the authors and do not necessarily represent the views of the National Center for Advancing Translational Sciences or the National Institutes of Health. This work was also completed through the support of General Electric, who provided the echocardiography equipment used for initial study completion.

Keywords

  • Rheumatic heart disease
  • echocardiography
  • quality improvement
  • screening

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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