HEART DISEASE SCREENING IN SCHOOL CHILDREN: COST
AND BENEFITS
Lue HC
Department of Pediatrics,
National Taiwan University, College of Medicine and Min-Sheng General
Hospital
Objective: To
detect congenital and acquired heart diseases among school children in
Taiwan, heart disease screening was conducted during 1997-2000.
Methods: A
total of 255,951 school children, aged 6-16 years, in primary, junior high
and high schools were screened, first by questionnaires and selected leads
ECG-PCG. 50,218 students (19.62%), who had either history and/or symptoms
and signs of heart disease and/or ECG and PCG changes, were subjected to
secondary screening by physical examination on supine position. 7,645 students (2.98%) with
suspected heart problems were then referred to a complete cardiac work-up
by pediatric cardiologists.
Results: Of
those 255,951 students screened, 3,610 students (14.1‰) had the heart
disease and/or ECG changes: Congenital heart disease (CHD) was identified
in 969 students (3.79‰), cardiomyopathy in 18 (0.07‰), rheumatic heart
disease 22 (0.08‰), Kawasaki disease 239 (0.93‰), mitral valve prolapse 365
(1.43‰), ECG abnormality 1,688 (6.60‰) and others 309 (1.21‰). Of those 3,610 cardiac problem,
2,112 (58.50%) were newly detected cases. Of the 969 students with CHD, 206 (21.26‰) were new
cases. Each case was treated
or managed. The average cost
spent in each student for primary and secondary screenings was NT$ 100.00
(US$ 3.1), and that for each cardiac work-up was NT$ 1,000 (US$31.0).
Conclusion: It is concluded that heart disease screening in school children
is beneficial and cost-effective.