Unrecognized congenital heart disease in rural school-age children: getting to the root of the problem

Congenital heart disease(CHD)is an important contribu-tor to morbidity and mortality in children,and the global burden of this illness has raised unique challenges to the healthcare system[1,2].China is among the countries with the highest burden of this disorder despite having achieved huge advances in cardiac surgery or interventional therapies in CHD during the past two decades[3].Interestingly and unexpected is the lower prevalence rate of CHD reported in China.The prevalence of CHD at live birth is estimated to be 9.4 per 1000 worldwide[4].However,this figure is much lower in China,with only 4.9 per 1000 live births between 2015 and 2019[5].