Multi-country Evaluation of Early RHD in Children Across Africa for Vaccine Trial Readiness (MEERCATS 1)

August 24, 2026 updated by: Children's Hospital Medical Center, Cincinnati

A Multinational Cohort Study to Determine the Incidence of Early Rheumatic Heart Disease (MEERCATS Study 1)

This study will look at how many children develop rheumatic heart disease (RHD) over a 3-year period. The study will include children ages 5 to 8 who do not have RHD at the start and who live in areas where the disease is common. Each child will have a heart ultrasound (echocardiogram) once a year for 3 years to check for signs of RHD. Doctors will diagnose RHD using internationally recognized guidelines from the World Heart Federation (2023). The study will also look at how often new cases occur each year, whether rates differ by age, sex, or location, and whether any children develop acute rheumatic fever during the study.

Study Overview

Status

Not yet recruiting

Conditions

Study Type

Observational

Enrollment (Estimated)

7500

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Mary Banks
  • Phone Number: 513-803-3123

Study Locations

  • Uganda
    • Uganda
      • Kampala, Uganda, Uganda

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Potential participants may be identified through locally approved school-based screening programs, community-based recruitment activities, existing demographic surveillance systems, or other locally appropriate community engagement mechanisms.

Description

Inclusion Criteria:

  • Age 5-8 years at enrollment
  • Residence within participating study catchment area
  • Parent/guardian able to provide informed consent
  • Participant able to provide assent where age-appropriate (country-specific, see below)
  • Normal baseline echocardiogram according to study screening protocol

Exclusion Criteria:

  • History of past ARF or RHD with or without cardiac involvement
  • Evidence of RHD at baseline screening
  • Congenital heart disease at baseline screening (excluding small PFO/ASD)
  • Medical conditions that would preclude safe participation or follow-up
  • Anticipated inability to complete study follow-up

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants with 3-Year Cumulative Incidence of Rheumatic Heart Disease
Time Frame: 3 years
Proportion of participants who develop RHD during the 3-year follow-up period, defined according to the 2023 World Heart Federation (WHF) echocardiographic criteria. Participants will be considered to have reached the endpoint if RHD is identified on any follow-up echocardiogram at 12, 24, or 36 months, or if they are diagnosed with acute rheumatic fever (ARF) during follow-up.
3 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of Newly Diagnosed Rheumatic Heart Disease
Time Frame: 12 months, 24 months, and 36 months
Incidence of newly diagnosed RHD at each annual assessment (12, 24, and 36 months), based on the 2023 WHF echocardiographic criteria.
12 months, 24 months, and 36 months
Number of Participants with RHD by Age Group
Time Frame: 3 years
Cumulative incidence of RHD stratified by age at enrollment (5-6 years versus 7-8 years).
3 years
Number of Participants with RHD by Sex
Time Frame: 3 years
Cumulative incidence of RHD stratified by participant sex.
3 years
Number of Participants with RHD by Geographic Location
Time Frame: 3 years
Cumulative incidence of RHD stratified by study site (Uganda, Malawi, and The Gambia)
3 years

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants with Acute Rheumatic Fever
Time Frame: 3 years
Number and proportion of participants diagnosed with acute rheumatic fever during follow-up, diagnosed according to the 2015 Revised Jones Criteria. ARF events will be monitored as a safety outcome.
3 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Children's Hospital Medical Center, Cincinnati

Collaborators

Murdoch Childrens Research Institute
Ochsner Health System
Uganda Heart Institute
Malawi Liverpool Wellcome Programme

Investigators

  • Principal Investigator: Andrea Beaton, Children's Hospital Medical Center, Cincinnati

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

February 1, 2027

Primary Completion (Estimated)

July 31, 2031

Study Completion (Estimated)

March 1, 2032

Study Registration Dates

First Submitted

August 24, 2026

First Submitted That Met QC Criteria

August 24, 2026

First Posted (Actual)

August 27, 2026

Study Record Updates

Last Update Posted (Actual)

August 27, 2026

Last Update Submitted That Met QC Criteria

August 24, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2026-0637

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Subscribe