Echocardiographic screening of schoolchildren in American Samoa to detect rheumatic heart disease: a feasibility study

Shawn S Barnes¹ James Sim² James R Marrone³ Venudhar D Reddy² Darragh C O’Carroll¹ Lauren Sumida¹ Guliz Erdem^2
1John A Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA; ²Department of Pediatrics, John A Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA; ³Department of Pediatrics, Lyndon Baines Johnson Tropical Medical Center, Pago Pago, American Samoa

Background: We report a practical and affordable pilot echocardiographic screening model for the detection of rheumatic heart disease (RHD) in Samoan children.
Materials and methods: Following a brief training period, three medical students recruited and screened 58.3% (N = 140) of schoolchildren aged 7–18 years on the remote Pacific island of Ta’u, American Samoa, performing echocardiography with a SonoSite^® portable ultrasound machine.
Results: None of the echocardiographic images obtained showed significant abnormality consistent with RHD on their review by two pediatric cardiologists on Oahu, Hawaii.
Conclusions: The implementation of echocardiographic screening in resource-poor regions with high rates of acute rheumatic fever and RHD, such as American Samoa, is feasible with limited training of personnel.

Keywords: pediatric, RHD, Samoa, schoolchildren, screening