During an evaluation of heart-disease screening methods among 17,366 Denver parochial school children, rheumatic heart disease (RHD) epidemiologic data were collected. The RHD prevalence rate was 1.7 cases per 1,000 enrolled. A history of rheumatic fever was elicited from 12.4% of the population and from 44.8% of the RHD cases. Prevalence rates of RHD and of rheumatic fever history were higher among older students and among those from lower socioeconomic circumstances. The excess RHD prevalence at the bottom of the socioeconomic scale was due largely to cases of RHD without a history of clinical rheumatic fever. Ethnic differences in RHD prevalence were believed to be explained by differences in their socioeconomic distributions, although there were insufficient data to satisfactorily document this hypothesis. RHD prevalence in students has apparently diminished during the past 40 years.
Morton WE, Huhn LA, Litchy JA. Rheumatic Heart Disease Epidemiology: Observations in 17,366 Denver School Children. JAMA. 1967;199(12):879–884. doi:10.1001/jama.1967.03120120067009
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