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

Published online by Cambridge University Press:  17 March 2016

Michelle Ploutz ,
Twalib Aliku ,
Tyler Bradley-Hewitt ,
Andrea Dantin ,
Bethan Lemley ,
Catherine W. Gillespie ,
Peter Lwabi ,
Craig Sable  and
Andrea Beaton
Michelle Ploutz*
Affiliation:
Division of Cardiology, Children’s National Health System, Washington, District of Columbia, United States of America
Twalib Aliku
Affiliation:
Division of Pediatric Cardiology, Gulu Regional Referral Hospital, Gulu, Uganda
Tyler Bradley-Hewitt
Affiliation:
Division of Cardiology, Children’s National Health System, Washington, District of Columbia, United States of America
Andrea Dantin
Affiliation:
University of St Augustine, Austin, Texas, United States of America
Bethan Lemley
Affiliation:
Division of Cardiology, Children’s National Health System, Washington, District of Columbia, United States of America
Catherine W. Gillespie
Affiliation:
AARP Public Policy Institute, Washington, District of Columbia, United States of America
Peter Lwabi
Affiliation:
Division of Pediatric Cardiology, Uganda Heart Institute, Kampala, Uganda
Craig Sable
Affiliation:
Division of Cardiology, Children’s National Health System, Washington, District of Columbia, United States of America
Andrea Beaton
Affiliation:
Division of Cardiology, Children’s National Health System, Washington, District of Columbia, United States of America
*
Correspondence to: Dr M. Ploutz, Division of Cardiology, Children’s National Health System, 111 Michigan Avenue NW, Washington, DC 20010, United States of America. Tel: +202 476 2020; Fax: +202 476 5700; E-mail: mploutz@childrensnational.org
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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.

Keywords

Rheumatic heart diseaseechocardiographyscreeningquality improvement
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 1 , January 2017 , pp. 82 - 89
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Copyright
© Cambridge University Press 2016 

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