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Heart Screening of School students, Khalanga, Jajarkot

 

A heart screening program of the school students was conducted on Khalanga, Jajarkot.  Jajarkot is 325 Km away from Kathmandu and is with the population of 171,304 and is considered the most remote and least developed upper hill district of Bheri Zone.  There is a high prevalence of stunting (52%), underweight (7%) and global acute malnutrition (13%) among children under five years of age.  This place is highly ecologically vulnerable as it is exposed to landslides and epidemics during July and August, snowfall in December and January and occasional fire incidents.

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Heart screening of 6147 students of 20 government schools took place on May 30-1st of June, screening people with involvement of cardiologists namely, Prof. Dr. Prakash Raj Regmi, Dr. Dev Neupane, Dr. Urmila Shakya, Dr. Rajan Poudel and other doctors namely Dr. Satya Narayan Suwal and Dr. Jigyasha Regmi Poudyal.  and other three medical team namely, Mr. Mohan Man Shrestha, Mr. Keshav Dhakal and Mr. Dipendra Poudel and other administrative team from Nepal Heart Foundation Central Office.  The program started from 9 AM in the morning and lasted until 4 PM.  In that heart screening program, 602 children were further tested by echocardiography machine.  A total of 60 cases (42 RHD and 18 CHD were detected from that event).  Prof. Dr. Prakash Raj Regmi, Dr. Urmila Shakya, Dr. Dev Neupane and Dr. Rajan Poudel conducted this echocardiography.

Heart Screening of School Students, Birgunj, Parsa

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A heart screening program of the public school students was conducted on Birgunj Parsa.  Birgunj is 135 Km south to Kathmandu and is the fifth largest city of Nepal while as second biggest city of Terai with population of around 133,238.  It has a border with India and is known as business hub for Nepal, especially for trade with India.  The city has high density of population and every year it is in increasing state.  Government schools of this area are filled with underserved students.

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Heart screening of 6573 students of six government schools took place on 13th and 14th of May, screening people in presence of cardiologists namely, Prof. Dr. Prakash Raj Regmi, Dr. Dev Neupane, Dr. Ajay Adhikari, and four other local doctors and other two medical team namely, Mr. Mohan Man Shrestha and Mr. Keshav Dhakal and other administrative team from Nepal Heart Foundation Central Office.  The program started from 9 AM in the morning and lasted until 4 PM.  In that heart screening program 658 children were further tested by echocardiography machine.  A total of 25 cases (16 RHD and 9 CHD were detected from that event).  Prof. Dr. Prakash Raj Regmi conducted this echocardiography.

Heart Screening of School Children, Khokana and kupondole, Lalitpur

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A heart screening program of the school students was conducted on two government schools of Khokana, and Pulchowk of Lalitpur district.  Khokana is an ancient city 3 Km south-west of the Kathmandu Valley.  It is a city with ancient value with lots of Newari inhabitants.  The city was demolished during the earthquake period and many of inhabitants are living still under low economic status.  Out-of-valley people working for rebuilding of Khokana are sparse in this city as well.  Government schools are occupied with children of those workers, who are underserved.  Family with affordable economic status normally sends their children to private school rather than to government school. Kupondole Lalitpur lies in the center of Lalitpur but still under served students are studying in the government schools.

The event took place on 9th of Feb, 2018 in presence of four cardiologists namely, Prof. Dr. Prakash Raj Regmi, Dr. Jigyasha Regmi Poudel, Dr. Satya Narayan Suwal, and Dr. Ajay Adhikari, along with four medical team namely, Mr. Anmol Maharjan, Mr. Mohan Man Shrestha, Mr. Keshav Dhakal, and Ms. Sangita Sharma Poudel.  The program started from 10 AM in the morning and lasted till 3 PM in the evening.  Total 761 students from two schools were screened, namely, Rudrayeni Sec. School (229), and Pragati Sikshya Sadan (532).  Student’s heart were screened with stethoscope by cardiologists for abnormal heart sound.  Among them 52 students were found to have abnormal heart sound and were examined by portable echocardiogphy machine at the scene for further investigation.  Five students were found to have congenital heart disease (CHD), 3 from Rudrayani, and 2 from Pragati.  Two were required to have surgical intervention and were referred to Sahid Gangalal National Heart Hospital.  A financial aid will be given to students to undergo treatment and/or surgery.

Heart Screenig of School Children, Kirtipur, Kathmandu

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A heart screening program of the school students was conducted on three government schools and one private school of Kirtipur, Kathmandu district. Kirtipur is an ancient city 5 Km south-west of the Kathmandu Valley of Newari habitant.  Due to the location of Tribhuvan University in this city, it is the popular area for out-of-town students and professors.  Very little damage during earthquake in this city has brought huge migration of out-of-valley people.  Most government schools are filled with the students out-of-town and students of low economic status who are underserved than the students of local habitant.  Family with affordable economic status normally sends their children to private school rather than to government school.

The event took place on 16th of March, 2018 in presence of six cardiologists namely, Prof. Dr. Prakash Raj Regmi, Dr. Jigyasha Regmi Poudel, Dr. Krishna Kumar Shrestha, Dr. Dev Neupane, Dr. Ajay Adhikari, Dr. Binayek Gautam and other four medical team namely, Mr. Anmol Maharjan, Mr. Mohan Man 

Shrestha, Mr. Keshav Dhakal, and Ms. Sangita Sharma Poudel.  The program started from 9AM in the morning and lasted till 5 PM in the evening.  Total of 3225 students from four schools were screened, namely, Jansewa Sec. School (1008), Panga Secondary School (438), Mangal Secondary School (715) and Creative Academy (1064).  Student’s heart were screened with stethoscope by cardiologists for abnormal heart sound.  Among them 208 students were found to have abnormal heart sound and were examined by portable echocardiogphy machine at the scene for further investigation. Four students were found to have congenital heart disease (CHD), 2 from Jansewa secondary school, 1 from Panga Secondary school and 1 from Mangal Secondary School.  Those four students were asked to visit Lalitpur Heart Clinic at Pulchowk where they will be further screened.  If they would require further investigation and/or treatment they will be referred to Sahid Gangalal National Heart Hospital.  A financial aid will be given to students to undergo treatment and/or surgery.

Public Awareness Program & Training :

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Beside heart screening of school children we conducted public awareness programs and training to teachers is several schools of Dhangadi and Dadeldhura. Thanks to our trainers Dr. Krishna Shrestha, Dr. Satya Narayan Suwal and RHD educator Keshab Dhakal and the supporting technicians Anmol Maharjan and Mohan Shrestha. Thank you boys! You all did a great job. 99% of the people of the far western Nepal were found to be unaware of the fact that untreated Tonsillitis may lead to Rheumatic heart disease. The strategy of our health ministry should be focused on primary and secondary prevention of RHD rather than free surgery of heart valve disease.

Heart screening at Dhangadi:

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We completed Heart check up of school children in Dhangadi and Dadeldhura of far western Nepal. Team of 5 physicians and 3 technicians conducted free heart check up of 9500 school children ( 6500 from 11 schools of Dhangadi and 3000 from 14 schools of Dadeldhura) on 2-5 May 2017 . Electrocardiography of around 900 children was done. 43 children with significant heart problems were diagnosed ( 29 from Dhangadi and 14 from Dadeldhura). Out of these 43 positive cases 21 children had Rheumatic heart disease ( 18 from Dhangadi and 3 from Dadeldhura) and 22 had Congenital heart disease ( 11 from Dhangadi and 11 from Dadeldhura)
Children had significantly higher rates of RHD than CHD in Dhangadi whereas in Dadeldhura it was just opposite. 6 children from Dadeldhura and 3 from Dhangadi were found to be in need of urgent heart surgeries. The organiser of this screening program Nepal heart foundation with support from Australian aid and Edwards foundation will be managing the free surgical and medical treatment of all the identified cases. I like to thank my whole team Dr. Suwal, Dr. Krishna Shrestha , Dr. Nirajan and Dr. Krishna Chandra Adhikari for their exclusive involvement in the screening program. RHD prevalence in Dhangadi was 3 per 1000 vs 1 per 1000 in Dadeldhura. Congenital heart disease prevalence in Dhangadi was 1.8 per 1000 vs 3.5 per 1000 in Dadeldhura. These are tentative data. Screening findings will be published. My conclusion is we need to focus RHD program in Terai and CHD program in mountain regions.

Heart screening at Gorkha:

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Nepal Heart Foundation conducted a Heart screening program in Gorkha District, in association with Medtronics Foundation on 15th and 16th of September. Nepal Heart Foundation, Gorkha Branch has facilitated this visit by coordinating with the school and health professionals for screening and training respectively. This visit was done with the purpose to screen the student for Rheumatic heart disease (RHD) and congenital heart disease (CHD) and to provide the training to the health professional

Introduction:

 

With the joint effort of Nepal Heart Foundation (NHF) and Direct Aid Program a School visit for Heart and Throat Screening of School's children of Age 3-18years was held.

 

Objectives:

 

The main objective of this visit was:

 

  1. To screen, detect and treat the children for tonsillitis and pharyngitis and heart disease due to the Rheumatic Heart Disease.

  2. To raise awareness among the school children regarding the RHD, Acute Rheumatic Fever and primary and secondary prevention of the Rheumatic Heart Disease.

  3. To support and refer the children for advanced support (surgery) in care of the critical condition due to the RHD.

 

 

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