Rapid Echocardiography for Congenital And Rheumatic heart Disease – Investigating a New Approach (RECARDINA)

Evaluation of two implementation strategies for a Rapid Echocardiography protocol to detect Congenital and Rheumatic heart Disease in school-based screening

The RECARDINA pilot project will evaluate two possible approaches to an innovative screening protocol for congenital and rheumatic heart disease (RHD) in school-aged children and young people, using briefly-trained healthcare workers conducting handheld, single parasternal long axis (PLAX) view echocardiography. Both approaches could potentially be scaled up to allow for screening very large numbers of children in a short period of time.

The first approach is a screen and refer approach, whereby briefly trained healthcare workers identify suspected abnormal scans, and refer these children on for further evaluation by a cardiologist; the second approach involves offsite expert review of all echocardiography images obtained by the briefly trained healthcare workers to identify which children have heart disease and require further follow up or treatment. This remote expert review will occur in ‘real-time’, with images obtained during the screening transmitted over a secure network to paediatric cardiologists in Australia.

The study site will be in Dili, the capital city of Timor-Leste, our closest northern neighbour where the burden of RHD is among the highest in the world.

The two approaches to screening will be evaluated in terms of which produces the highest yield of significant heart disease cases, and which is most cost efficient for scaling up active case finding activities in settings with limited resources and a high burden of undetected RHD.

This study will provide preliminary data necessary to inform the design and implementation of large-scale RHD screening activities and trials, which will further our knowledge of epidemiology and disease progression, and the treatment of screening-detected RHD.

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