{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:21:17Z","timestamp":1789147277126,"version":"build-2803163510"},"reference-count":33,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rheumatic heart disease (RHD) is a sequela of recurrent, untreated group A Streptococcus infections. RHD disproportionately affects children and young adults in the Global South. Intermittent mass screening of early RHD by using affordable tools in these disease-endemic regions is essential for effective prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined multimodal physiological data for assessing the prevalence of early RHD in a cohort of asymptomatic, at-risk students in rural Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 584 asymptomatic children aged 10 to 20 years were randomly selected for screening and stratified into 2 groups (\u226414 and &gt;14 years). Electrocardiogram, phonocardiogram, and echocardiography screening were performed, with diagnoses based on the 2012 World Heart Federation criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After excluding 1.4% (8\/584) of the children, who had nonrheumatic findings, 576 participants were analyzed, including 334 (58.0%) female and 242 (42.0%) male children. The mean age was 16.1 (SD 2.4) years (95% CI 15.9-16.3). Echocardiographic screening identified 19 cases of RHD (n=10, 52.6% borderline and n=9, 47.4% definite). Female children accounted for 68.4% (13\/19) of cases, and the association between female sex and RHD was not statistically significant (odds ratio 1.59, 95% CI 0.60-4.25; P=.35). The estimated prevalence of RHD was 32.5 per 1000 population (95% CI 18.1-46.9; SE 7.4; 19\/576, 3.3%), which was significantly higher than the most recent multicenter prevalence estimate of 19 per 1000 population (95% CI 13.9-23.4; odds ratio 2.12; P=.03). Mitral regurgitation was the predominant lesion (16\/19, 84.2%), followed by mitral stenosis (2\/19, 10.5%) and aortic regurgitation (1\/19, 5.3%). Phonocardiogram analysis showed mitral regurgitation (10\/19, 52.6%), mitral stenosis (2\/19, 10.5%), and subclinical findings in the rest of patients with RHD. Prolonged PR intervals were observed in 10.5% (2\/19) of the RHD-positive participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study confirms persistent high prevalence of asymptomatic RHD among students in rural regions of Ethiopia. Although there was a female predominance in RHD incidence, the difference between the sexes was not statistically significant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/87039","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T13:55:06Z","timestamp":1772027706000},"page":"e87039","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence of Early Rheumatic Heart Disease Among Asymptomatic Students in Underserved Communities in Ethiopia: Cross-Sectional Observational Study"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5032-4797","authenticated-orcid":false,"given":"Amsalu Tomas","family":"Chuma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7088-1216","authenticated-orcid":false,"given":"Desalew 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