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Karthikeyan G, Ntsekhe M, Islam S, Rangarajan S, Avezum A, Benz A, Cabral TTJ, Changsheng M, Chillo P, Gonzalez-Hermosillo JA, Gitura B, Damasceno A, Dans AML, Davletov K, Elghamrawy A, ElSayed A, Fana GT, Gondwe L, Haileamlak A, Kayani AM, Lwabi P, Maklady F, Molefe-Baikai OJ, Musuku J, Ogah OS, Paniagua M, Rusingiza E, Sharma SK, Zuhlke L, Connolly S, Yusuf S. Mortality and Morbidity in Adults With Rheumatic Heart Disease. JAMA 2024; 332:133-140. [PMID: 38837131 PMCID: PMC11154374 DOI: 10.1001/jama.2024.8258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/18/2024] [Indexed: 06/06/2024]
Abstract
Importance Rheumatic heart disease (RHD) remains a public health issue in low- and middle-income countries (LMICs). However, there are few large studies enrolling individuals from multiple endemic countries. Objective To assess the risk and predictors of major patient-important clinical outcomes in patients with clinical RHD. Design, Setting, and Participants Multicenter, hospital-based, prospective observational study including 138 sites in 24 RHD-endemic LMICs. Main Outcomes and Measures The primary outcome was all-cause mortality. Secondary outcomes were cause-specific mortality, heart failure (HF) hospitalization, stroke, recurrent rheumatic fever, and infective endocarditis. This study analyzed event rates by World Bank country income groups and determined the predictors of mortality using multivariable Cox models. Results Between August 2016 and May 2022, a total of 13 696 patients were enrolled. The mean age was 43.2 years and 72% were women. Data on vital status were available for 12 967 participants (94.7%) at the end of follow-up. Over a median duration of 3.2 years (41 478 patient-years), 1943 patients died (15% overall; 4.7% per patient-year). Most deaths were due to vascular causes (1312 [67.5%]), mainly HF or sudden cardiac death. The number of patients undergoing valve surgery (604 [4.4%]) and HF hospitalization (2% per year) was low. Strokes were infrequent (0.6% per year) and recurrent rheumatic fever was rare. Markers of severe valve disease, such as congestive HF (HR, 1.58 [95% CI, 1.50-1.87]; P < .001), pulmonary hypertension (HR, 1.52 [95% CI, 1.37-1.69]; P < .001), and atrial fibrillation (HR, 1.30 [95% CI, 1.15-1.46]; P < .001) were associated with increased mortality. Treatment with surgery (HR, 0.23 [95% CI, 0.12-0.44]; P < .001) or valvuloplasty (HR, 0.24 [95% CI, 0.06-0.95]; P = .042) were associated with lower mortality. Higher country income level was associated with lower mortality after adjustment for patient-level factors. Conclusions and Relevance Mortality in RHD is high and is correlated with the severity of valve disease. Valve surgery and valvuloplasty were associated with substantially lower mortality. Study findings suggest a greater need to improve access to surgical and interventional care, in addition to the current approaches focused on antibiotic prophylaxis and anticoagulation.
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Kayembe Ntumba JM, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mavis Mulaudzi F, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Sahar Yassien M, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: Urgent action needed for Africa and the world: Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change. Neurooncol Pract 2024; 11:e4-e6. [PMID: 38737601 PMCID: PMC11085826 DOI: 10.1093/nop/npac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Kayembe Ntumba JM, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mavis Mulaudzi F, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Sahar Yassien M, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: urgent action needed for Africa and the world. THE GERONTOLOGIST 2024; 64:gnac156. [PMID: 36257660 PMCID: PMC10946412 DOI: 10.1093/geront/gnac156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: urgent action needed for Africa and the world. Eur Heart J 2023; 44:4911-4912. [PMID: 36257656 PMCID: PMC10719498 DOI: 10.1093/eurheartj/ehac583] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: Urgent action needed for Africa and the world. Med Mycol 2023; 61:myac082. [PMID: 36257666 PMCID: PMC10558093 DOI: 10.1093/mmy/myac082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Haileamlak A. A Brief Overview of Bioethics. Ethiop J Health Sci 2023; 33:390. [PMID: 37576176 PMCID: PMC10416332 DOI: 10.4314/ejhs.v33i3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
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Haileamlak A, Ataro I. The Ethiopian Health Extension Program (HEP) is Still Relevant After 15 Years of Implementation Although Major Transformation is Essential to Sustain Its Gains and Relevance. Ethiop J Health Sci 2023; 33:1-2. [PMID: 38362471 PMCID: PMC10866294 DOI: 10.4314/ejhs.v33i1.1s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Kayembe Ntumba JM, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mavis Mulaudzi F, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Sahar Yassien M, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: Urgent Action Needed for Africa and the World. Schizophr Bull 2023; 49:231-233. [PMID: 36257668 PMCID: PMC10016397 DOI: 10.1093/schbul/sbac156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: urgent action needed for Africa and the world. Eur J Cardiovasc Nurs 2023; 22:e12-e13. [PMID: 36257662 DOI: 10.1093/eurjcn/zvac094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Erhabor GE, Zakhama L, Yonga P, Sahar Yassien M, Tumwine J, Snouber A, Sidibé S, Rashidian A, Okonofua F, Ofori-Adjei D, Mulaudzi FM, Muhia J, Mash B, Kigera J, Kayembe Ntumba JM, Haileamlak A, Gbakima AA, Zielinski C. COP27 Climate Change Conference: Urgent Action Needed for Africa and the World. INTERNATIONAL JOURNAL OF MEDICAL STUDENTS 2023. [DOI: 10.5195/ijms.2022.1693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Kayembe Ntumba JM, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mavis Mulaudzi F, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Sahar Yassien M, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: urgent action needed for Africa and the world. Occup Med (Lond) 2023; 73:4-6. [PMID: 36257667 PMCID: PMC9927815 DOI: 10.1093/occmed/kqac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: urgent action needed for Africa and the world. TROP J PHARM RES 2023. [DOI: 10.4314/tjpr.v21i11.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
COP27 Climate Change Conference: urgent action needed for Africa and the world
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: Urgent action needed for Africa and the world. Int J Lab Hematol 2023; 45:3-5. [PMID: 36259685 DOI: 10.1111/ijlh.13980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference-Urgent Action Needed for Africa and the World. JAMA Oncol 2023; 9:173-175. [PMID: 36383449 DOI: 10.1001/jamaoncol.2022.6371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: Urgent action needed for Africa and the world. Int J Gynaecol Obstet 2023; 160:391-393. [PMID: 36257664 DOI: 10.1002/ijgo.14463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: urgent action needed for Africa and the world. Eur J Prev Cardiol 2023; 30:98-100. [PMID: 36257653 DOI: 10.1093/eurjpc/zwac230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference-Urgent Action Needed for Africa and the World. JAMA Cardiol 2023; 8:10-11. [PMID: 36383463 DOI: 10.1001/jamacardio.2022.4517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference-Urgent Action Needed for Africa and the World. JAMA Intern Med 2023; 183:9-10. [PMID: 36383454 DOI: 10.1001/jamainternmed.2022.5640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: Urgent action needed for Africa and the world. Allergy 2023; 78:17-19. [PMID: 36257669 DOI: 10.1111/all.15523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 12/30/2022]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: Urgent action needed for Africa and the world. Equine Vet J 2023; 55:9-11. [PMID: 36259122 DOI: 10.1111/evj.13882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference-Urgent Action Needed for Africa and the World. JAMA Ophthalmol 2023; 141:11-12. [PMID: 36383466 DOI: 10.1001/jamaophthalmol.2022.5271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: Urgent action needed for Africa and the world. Indian J Med Ethics 2023; VIII:7-9. [PMID: 36352544 DOI: 10.20529/ijme.2022.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The 2022 report of the Intergovernmental Panel on Climate Change (IPCC) paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction, and climate hazards such as heatwaves and floods [1]. These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these catastrophic health effects across all regions of the globe, there is broad agreement - as 231 health journals argued together in 2021 - that the rise in global temperature must be limited to less than 1.5oC compared with pre-industrial levels.
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash B, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference-Urgent Action Needed for Africa and the World. JAMA Pediatr 2023; 177:11-13. [PMID: 36383448 DOI: 10.1001/jamapediatrics.2022.4899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash R, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: urgent action needed for Africa and the world. THE LANCET GLOBAL HEALTH 2023; 11:e18-e20. [PMID: 36272437 DOI: 10.1016/s2214-109x(22)00457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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