Prevalence of RHD, Pyoderma and Scabies in Children in Fiji
Condition: Streptococcus Group A
MeSH terms: Scabies; Pyoderma
Study type: Observational

Summary: 
      The purpose of this study is to estimate the number of cases of rheumatic heart disease,
      pyoderma, and scabies in school age children in Fiji. In addition the study will describe the
      features of rheumatic heart disease, pyoderma, and scabies in these children. Study
      participants will include 5200 primary school children, ages 5-14, from 21 primary schools in
      the Central Division of Fiji. These children will be examined for pyoderma, scabies, and the
      doctor will listen to their heart with a stethoscope. Any child that has a heart murmur
      detected will have their heart looked at through an echocardiogram test (uses sound waves to
      create a picture of how the heart is working). Any child that is found to have rheumatic
      heart disease will be referred to a pediatric cardiologist for further evaluation.
      Participants will be involved in the study for about 2 days.
    

Detailed description: 
      This study is the first of 5 studies (including DMID protocols 05-0081, 05-0082, 05-0117, and
      06-0081) in a larger project aimed at evaluating the epidemiology of infections caused by the
      group A streptococcus (GAS) in Fiji - this larger project is called the Fiji Group A
      Streptococcal Project (Fiji GrASP). Fiji GrASP is in turn part of a larger program aimed at
      progression of a novel GAS vaccine - this program is the project entitled "Global GAS Vaccine
      Based On The M-Protein". The three broad aims of the Fiji GrASP epidemiologic studies are to:
      establish the burden of disease of GAS infections in Fiji; describe the molecular
      epidemiology of GAS isolates in Fiji; and establish natural immunologic correlates of
      protection of a J8 vaccine if they exist. The Fiji GrASP epidemiologic studies are important
      for vaccine clinical trials in that they will gain a clear picture of the burden of GAS
      disease, develop ongoing surveillance and clinical endpoints for vaccine trials, collect
      isolates of GAS in Fiji, investigate immune correlates of vaccine protection, and prepare the
      existing clinical trial site for trials of the J-8 based vaccine. The primary objectives of
      this study are to estimate the prevalence of rheumatic heart disease (RHD) in primary school
      aged children in Fiji and to estimate the prevalence of pyoderma in these children. Secondary
      objectives are to: estimate the prevalence of scabies in primary school aged children in
      Fiji; describe the clinical and echocardiographic features of RHD in these children; and
      describe the clinical features of pyoderma and scabies in these children. Approximately 5,200
      primary school children, 5-14 years of age, from 21 primary schools in the Central Division
      of Fiji will participate in this study. They will be examined for pyoderma and scabies, and
      they will have a standard auscultation by a pediatrician. Any child with a murmur will have a
      screening echocardiogram of the mitral and aortic valves. If abnormality of these valves is
      identified or if another pathology is suspected, the child will be referred to a pediatric
      cardiologist for full echocardiogram. The primary endpoints of the study will be to determine
      the prevalence of echocardiogram confirmed rheumatic heart disease and to determine the
      prevalence of pyoderma assessed using a standardized tool. The secondary endpoints will be to
      determine: prevalence of scabies assessed using a standardized tool; prerevalence of heart
      failure or signs of ventricular enlargement in children with echocardiographically-confirmed
      RHD; distribution and severity of valvular lesions in children with
      echocardiographically-confirmed RHD; prevalence of severe pyoderma and body distribution
      (upper vs lower) of lesions; and prevalence of scabies, severe scabies and body distribution
      (upper vs lower) of scabies lesions.
    

Time perspective: Prospective
Keywords: Streptococcus, Fiji, pyoderma, scabies, rheumatic disease