Tulsipur

This research aims to evaluate how effective a school-centered program is at preventing latent rheumatic heart disease among schoolchildren in Nepal. It also investigates how socioeconomic and environmental factors influence the development and progression of this disease. Rheumatic heart disease is a serious condition affecting many children worldwide, especially in regions where group A beta-hemolytic streptococcal GAHBS infections are common, which can lead to acute rheumatic fever and heart damage. The study involves implementing a dedicated school nurse program at Tulsi Secondary Boarding School, focusing on assessing, intervening, and following up on cases of GAHBS pharyngitis. This program also facilitates secondary antibiotic prevention for children identified with latent rheumatic heart disease through echocardiography screening. The program is designed to provide timely detection and treatment to reduce the disease burden through primary and secondary prevention efforts. Participants, children aged 5 to 16 years attending the school, will undergo echocardiography before the program starts and again two and four years after implementation to measure the prevalence of latent rheumatic heart disease. Researchers will collect sociodemographic information through interviews and monitor outcomes such as GAHBS pharyngitis, acute rheumatic fever, and adverse reactions to penicillin. This longitudinal approach aims to assess the programs impact on disease prevalence and identify factors related to disease progression over a four-year period.