UMMS Affiliation

Department of Population and Quantitative Health Sciences

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Cardiology | Cardiovascular Diseases | Epidemiology | Health Services Research | International Public Health | Public Health Education and Promotion


OBJECTIVES: We examined the level of awareness about Rheumatic Heart Disease (RHD) among school-aged children in a rural district of India and evaluated the effects of a questionnaire-based survey in improving the level of awareness.

METHODS: The study involved 8,646 students aged 10-16 years from 20 schools in West Midnapore, India which was conducted in August 2017. We examined changes in the level of awareness of RHD using a 29-point scoring system in seven domains. The baseline questionnaire survey assessed students' knowledge and was followed by a multimedia presentation about RHD and a post-intervention survey using the same questionnaire. The questionnaire included 9 questions on different aspects of RHD including prevalence, nature of disease, symptoms, determinants, treatment options, impact of the disease and diagnosis.

RESULTS: The mean age of the study population was 13 years and 46% were boys. At baseline, the mean level of knowledge about RHD was 42% (12.2 out of 29 points). After the school-based presentation, the score improved to a mean of 55% (15.9 points on the 29-point scale), a 31% relative improvement. Improvement in students' knowledge was noted across all seven domains, individually and combined (p < 0.001).

CONCLUSIONS: Awareness among children in rural India about RHD is modest. A school-based intervention could help in improving awareness about this chronic condition and may promote secondary prophylaxis to reduce the morbidity and mortality from RHD.


Rheumatic heart disease, Early detection, Developing countries, Educational intervention, Secondary prophylaxis

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© 2020 Published by Elsevier B.V. on behalf of Cardiological Society of India. This is an open access article under the CC BY-NC-ND license (

DOI of Published Version



Ray M, Guha S, Ray M, Karak A, Choudhury B, Ray B, Hazra PC, Selker HP, Goldberg RJ, Bhatt DL. A questionnaire survey for improving awareness of rheumatic heart disease among school-aged children in India. Indian Heart J. 2020 Sep-Oct;72(5):410-415. doi: 10.1016/j.ihj.2020.08.004. Epub 2020 Aug 9. PMID: 33189203; PMCID: PMC7670277. Link to article on publisher's site

Journal/Book/Conference Title

Indian heart journal

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.