{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:40:22Z","timestamp":1791211222477,"version":"4.1.0"},"reference-count":31,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2009,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To determine the prevalence of rheumatic heart disease (RHD) among school children in urban and semiurban areas of Lahore, Pakistan.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>A cross-sectional survey of school children aged 5\u201315 years from 70 schools of urban and semiurban Lahore was carried out by a team of cardiologists. Children were screened by clinical examination and diagnosis confirmed by echocardiography. Sociodemographic data were also collected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>Of 24\u2009980 children screened, 986 (3.9%) had a confirmed cardiac lesion; 546 had RHD, 440 had congenital heart disease. The prevalence of RHD was 21.9\/1000 children screened (95% CI 20.1 to 23.7). Their mean (SD) age was 10.7 (2.6) years and the female:male ratio was 1.6:1. Most (92.5%) were unaware of the diagnosis and less than 2% were taking rheumatic prophylaxis. All children belonged to a low socioeconomic group and 67% were undernourished.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>The prevalence of RHD in the urban school population of Lahore is among the highest in the world. The younger age of onset is a special feature and most are unaware of the diagnosis, and hence not receiving life-saving secondary prophylaxis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/hrt.2008.143982","type":"journal-article","created":{"date-parts":[[2008,10,24]],"date-time":"2008-10-24T20:25:18Z","timestamp":1224879918000},"page":"353-357","source":"Crossref","is-referenced-by-count":44,"title":["Prevalence of rheumatic heart disease in school children of urban Lahore"],"prefix":"10.1136","volume":"95","author":[{"given":"M","family":"Sadiq","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Islam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Abid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Latif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A U","family":"Rehman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Waheed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Azhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J S","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2008,10,24]]},"reference":[{"key":"2025101713293671000_95.5.353.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70267-X"},{"key":"2025101713293671000_95.5.353.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa065085"},{"key":"2025101713293671000_95.5.353.3","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1097\/00006454-199110001-00003","article-title":"Streptococcal disease in developing countries.","volume":"10","author":"Markowitz","year":"1991","journal-title":"Pediatr Infect Dis J"},{"key":"2025101713293671000_95.5.353.4","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.2105\/AJPH.90.8.1235","article-title":"Applying burden of disease methods in developing countries: a case study from Pakistan.","volume":"90","author":"Hyder","year":"2000","journal-title":"Am J Public Health"},{"key":"2025101713293671000_95.5.353.5","first-page":"544","article-title":"An epidemiological study of heart disease in Pakistan.","volume":"18","author":"Hashmi","year":"1966","journal-title":"J Pakistan Med Assoc"},{"key":"2025101713293671000_95.5.353.6","unstructured":"Syed SA Raza M Hashmi JA . Establishment of comprehensive research and rehabilitation program for persons of various forms of heart disease. Project. V R A Pak. Karachi: National Institute of Cardiovascular Disease, 1973:8\u201366."},{"key":"2025101713293671000_95.5.353.7","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.025981"},{"key":"2025101713293671000_95.5.353.8","first-page":"300","article-title":"Incidence of heart disease in children at the National Institute of Cardiovascular Diseases.","volume":"34","author":"Aziz","year":"1984","journal-title":"J Pakistan Med Assoc"},{"key":"2025101713293671000_95.5.353.9","first-page":"149","article-title":"Pattern of paediatric heart disease in Pakistan.","volume":"12","author":"Sadiq","year":"2002","journal-title":"Journal of the College of Physicians and Surgeons Pakistan"},{"key":"2025101713293671000_95.5.353.10","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(66)90008-7"},{"key":"2025101713293671000_95.5.353.11","first-page":"2","article-title":"Prevalence of heart disease in school children of Islamabad.","volume":"14","author":"Malik","year":"1981","journal-title":"Pakistan Heart J"},{"key":"2025101713293671000_95.5.353.12","first-page":"165","article-title":"Prevalence and pattern of rheumatic heart disease in the Frontier province of Pakistan.","volume":"29","author":"Ilyas","year":"1979","journal-title":"J Pakistan Med Assoc"},{"key":"2025101713293671000_95.5.353.13","unstructured":"Anonymous. Proceedings of Second National Workshop on WHO Global Programme for Prevention of Rheumatic Fever\/Rheumatic Heart Disease, Islamabad, 10\u201312 June 1989."},{"key":"2025101713293671000_95.5.353.14","unstructured":"Anonymous. Government of Pakistan, Ministry of Finance. Economic survey 2000\u20132001 Table 12.4, Population by age, sex urban\/rural areas 1981 and 1998 census."},{"key":"2025101713293671000_95.5.353.15","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.75.1.175"},{"key":"2025101713293671000_95.5.353.16","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1002\/clc.4960201105","article-title":"Doppler echocardiography distinguishes between physiologic and pathologic silent mitral regurgitations in patients with rheumatic fever.","volume":"20","author":"Minich","year":"1997","journal-title":"Clin Cardiol"},{"key":"2025101713293671000_95.5.353.17","first-page":"302","article-title":"Guidelines for the diagnosis of rheumatic fever: Jones criteria, updated 1992.","volume":"87","author":"Dajani","year":"1993","journal-title":"Circulation"},{"key":"2025101713293671000_95.5.353.18","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.2002.00772.x"},{"key":"2025101713293671000_95.5.353.19","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/S0167-5273(97)00311-2","article-title":"Survey of rheumatic heart disease in school children of Kinshasa town.","volume":"63","author":"Longo-Mbenza","year":"1999","journal-title":"Int J Cardiol"},{"key":"2025101713293671000_95.5.353.20","first-page":"245","article-title":"Rheumatic heart disease: a school survey in a rural area of Rajasthan.","volume":"44","author":"Kumar","year":"1992","journal-title":"Indian Heart J"},{"key":"2025101713293671000_95.5.353.21","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1172\/JCI114071","article-title":"Presence of a non-HLA B cell antigen in rheumatic fever patients and their families as defined by a monoclonal antibody.","volume":"83","author":"Khanna","year":"1989","journal-title":"J Clin Invest"},{"key":"2025101713293671000_95.5.353.22","doi-asserted-by":"publisher","DOI":"10.1186\/ar1000"},{"key":"2025101713293671000_95.5.353.23","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/159.1.101"},{"key":"2025101713293671000_95.5.353.24","unstructured":"Martin D Sriprakash K . 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Melbourne: Australian Society for Microbiology, 1997:1\u201340."},{"key":"2025101713293671000_95.5.353.25","first-page":"1","article-title":"Rheumatic fever and rheumatic heart disease: report of a WHO expert consultation.","volume":"923","author":"Anonymous","year":"2004","journal-title":"World Health Organ Tech Rep Ser"},{"key":"2025101713293671000_95.5.353.26","first-page":"215","article-title":"Prevalence of heart disease in school children in rural Kenya using colour-flow echocardiography.","volume":"73","author":"Anabwani","year":"1996","journal-title":"East Afr Med J"},{"key":"2025101713293671000_95.5.353.27","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/S0140-6736(63)92922-2","article-title":"Juvenile mitral stenosis in India.","volume":"ii","author":"Roy","year":"1963","journal-title":"Lancet"},{"key":"2025101713293671000_95.5.353.28","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(94)90199-6"},{"key":"2025101713293671000_95.5.353.29","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951103000064"},{"key":"2025101713293671000_95.5.353.30","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.118810"},{"key":"2025101713293671000_95.5.353.31","unstructured":"Anonymous. ASAP: Rheumatic fever and rheumatic heart disease. Available at http:\/\/www.pascar.co.za\/C_ASAP.asp (accessed 13 November 2008)."}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.2008.143982","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T20:29:48Z","timestamp":1760732988000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.2008.143982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,10,24]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2009,2,13]]},"published-print":{"date-parts":[[2009,3]]}},"alternative-id":["10.1136\/hrt.2008.143982"],"URL":"https:\/\/doi.org\/10.1136\/hrt.2008.143982","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,10,24]]}}}