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Shimanda PP, Shumba TW, Brunström M, Iipinge SN, Söderberg S, Lindholm L, Norström F. Preventive Interventions to Reduce the Burden of Rheumatic Heart Disease in Populations at Risk: A Systematic Review. J Am Heart Assoc 2024; 13:e032442. [PMID: 38390809 PMCID: PMC10944073 DOI: 10.1161/jaha.123.032442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/30/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Rheumatic heart disease (RHD) is a devastating yet preventable condition that disproportionately affects low-middle-income countries and indigenous populations in some high-income countries. Various preventive interventions have been implemented across the globe, but evidence for the effectiveness of these measures in reducing the incidence or prevalence of acute rheumatic fever and RHD is scattered. This systematic review aims to assess the effectiveness of preventive interventions and identify the strategies used to reduce the burden of RHD. METHODS AND RESULTS A comprehensive search was conducted to identify relevant studies on RHD prevention interventions including interventions for primordial, primary, and secondary prevention. Effectiveness measures for the interventions were gathered when available. The findings indicate that school-based primary prevention services targeting the early detection and treatment of Group A Streptococcus pharyngitis infection with penicillin have the potential to reduce the incidence of Group A Streptococcus pharyngitis and acute rheumatic fever. Community-based programs using various prevention strategies also reduced the burden of RHD. However, there is limited evidence from low-middle-income countries and a lack of rigorous evaluations reporting the true impact of the interventions. Narrative synthesis was performed, and the methodological quality appraisal was done using the Joanna Briggs Institute critical appraisal tools. CONCLUSIONS This systematic review underscores the importance of various preventive interventions in reducing the incidence and burden of Group A Streptococcus pharyngitis, acute rheumatic fever, and RHD. Rigorous evaluations and comprehensive analyses of interventions are necessary for guiding effective strategies and informing public health policies to prevent and reduce the burden of these diseases in diverse populations. REGISTRATION URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42020170503.
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Affiliation(s)
| | - Tonderai W Shumba
- Department of Occupational Therapy and Physiotherapy University of Namibia Windhoek Namibia
| | - Mattias Brunström
- Department of Public Health and Clinical Medicine, Cardiology Umeå University Umeå Sweden
| | | | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Cardiology Umeå University Umeå Sweden
| | - Lars Lindholm
- Department of Epidemiology and Global Health Umeå University Umeå Sweden
| | - Fredrik Norström
- Department of Epidemiology and Global Health Umeå University Umeå Sweden
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Beyersdorf F. Innovation and disruptive science determine the future of cardiothoracic surgery. Eur J Cardiothorac Surg 2024; 65:ezae022. [PMID: 38243711 DOI: 10.1093/ejcts/ezae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/12/2024] [Indexed: 01/21/2024] Open
Abstract
One of the currently most asked questions in the field of medicine is how any specialty in the future will evolve to ensure better health for the patients by using current, unparalleled developments in all areas of science. This article will give an overview of new and evolving strategies for cardiothoracic (CT) surgery that are available today and will become available in the future in order to achieve this goal. In the founding era of CT surgery in the 1950s and 1960s, there was tremendous excitement about innovation and disruptive science, which eventually resulted in a completely new medical specialty, i.e. CT surgery. Entirely new treatment strategies were introduced for many cardiovascular diseases that had been considered incurable until then. As expected, alternative techniques have evolved in all fields of science during the last few decades, allowing great improvements in diagnostics and treatment in all medical specialties. The future of CT surgery will be determined by an unrestricted and unconditional investment in innovation, disruptive science and our own transformation using current achievements from many other fields. From the multitude of current and future possibilities, I will highlight 4 in this review: improvements in our current techniques, bringing CT surgery to low- and middle-income countries, revolutionizing the perioperative period and treating as yet untreatable diseases. These developments will allow us a continuation of the previously unheard-of treatment possibilities provided by ingenious innovations based on the fundamentals of CT surgery.
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Affiliation(s)
- Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, University Hospital Freiburg, Freiburg, Germany
- Medical Faculty of the Albert-Ludwigs-University Freiburg, Germany
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3
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Rheumatic heart disease in The Gambia: clinical and valvular aspects at presentation and evolution under penicillin prophylaxis. BMC Cardiovasc Disord 2021; 21:503. [PMID: 34663206 PMCID: PMC8525010 DOI: 10.1186/s12872-021-02308-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rheumatic heart disease (RHD) remains the leading cause of cardiac-related deaths and disability in children and young adults worldwide. In The Gambia, the RHD burden is thought to be high although no data are available and no control programme is yet implemented. We conducted a pilot study to generate baseline data on the clinical and valvular characteristics of RHD patients at first presentation, adherence to penicillin prophylaxis and the evolution of lesions over time. METHODS All patients registered with acute rheumatic fever (ARF) or RHD at two Gambian referral hospitals were invited for a clinical review that included echocardiography. In addition, patients were interviewed about potential risk factors, disease history, and treatment adherence. All clinical and echocardiography information at first presentation and during follow-up was retrieved from medical records. RESULTS Among 255 registered RHD patients, 35 had died, 127 were examined, and 111 confirmed RHD patients were enrolled, 64% of them females. The case fatality rate in 2017 was estimated at 19.6%. At first presentation, median age was 13 years (IQR [9; 18]), 57% patients had late stage heart failure, and 84.1% a pathological heart murmur. Although 53.2% of them reported history of recurrent sore throat, only 32.2% of them had sought medical treatment. A history suggestive of ARF was reported by 48.7% patients out of whom only 15.8% were adequately treated. Two third of the patients (65.5%) to whom it was prescribed were fully adherent to penicillin prophylaxis. Progressive worsening and repeated hospitalisation was experienced by 46.8% of the patients. 17 patients had cardiac surgery, but they represented only 18.1% of the 94 patients estimated eligible for cardiac surgery. CONCLUSION This study highlights for the first time in The Gambia the devastating consequences of RHD on the health of adolescents and young adults. Our findings suggest a high burden of disease that remains largely undetected and without appropriate secondary prophylaxis. There is a need for the urgent implementation of an effective national RHD control programto decrease the unacceptably high mortality rate, improve case detection and management, and increase community awareness of this disease.
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Norton L, Myers A. The treatment of streptococcal tonsillitis/pharyngitis in young children. World J Otorhinolaryngol Head Neck Surg 2021; 7:161-165. [PMID: 34430823 PMCID: PMC8356196 DOI: 10.1016/j.wjorl.2021.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 11/22/2022] Open
Abstract
Pharyngitis is common in children, accounting for nearly 12 million visits annually in the United States. Streptococcus pyogenes or group A streptococcus (GAS) is the most common bacterial cause of pharyngitis for which antibiotics are indicated. Antibiotic treatment of streptococcal pharyngitis virtually eliminates the presence of bacteria from the pharynx and thus removes the risk of subsequent rheumatic fever. GAS is spread from person to person via respiratory droplets with a short incubation period of 2∼5 days. GAS pharyngitis peaks in the late winter and early spring months when children are predominately indoors for school and sports. Colonization is also higher in winter months, and while up to 20% of school age children are colonized with GAS in their throat during this time, colonization has not been shown to contribute to the spread of disease. In low- and middle-income countries and other situations in which crowding is common (e.g., schools), outbreaks of pharyngitis are common. GAS pharyngitis can occur at all ages and it is most common in school-aged children with a peak at 7∼8 years of age. Pharyngitis caused by GAS is rare in children <3 years of age and becomes much less common in late adolescence through adulthood.
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Affiliation(s)
| | - Angela Myers
- Pediatrics Children's Mercy Hospital, USA
- Corresponding author.
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Chotivatanapong T. Rheumatic mitral valve repair: a personal perspective and results. Asian Cardiovasc Thorac Ann 2020; 28:366-370. [DOI: 10.1177/0218492320927315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rheumatic mitral valve disease remains a challenge for cardiac surgeons. Valve repair has several advantages over valve replacement but is technically demanding for good results. To improve rheumatic mitral valve repair, surgeons need to have a deep understand of the mitral valve complex and its dynamics. The goal of repair is to restore normal diastolic and systolic function. The current approach is to perform a holistic repair of the entire mitral complex. Each part of the complex is thoroughly explored to define the problem. Several innovative techniques have been introduced to correct valve dysfunction and provide gratifying results. The details of these techniques will be described, based on an understanding of the relationship of the mitral valve complex and dynamics. With this approach, rheumatic mitral valve repair is becoming more successful, reproducible, and safe. Long-term follow-up is mandatory.
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Affiliation(s)
- Taweesak Chotivatanapong
- Department of Cardiothoracic Surgery, International Academic Institute Program, Central Chest Institute of Thailand, Nonthaburi, Thailand
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Byiringiro S, Nyirimanzi N, Mucumbitsi J, Kamanzi ER, Swain J. Cardiac Surgery: Increasing Access in Low- and Middle-Income Countries. Curr Cardiol Rep 2020; 22:37. [PMID: 32430786 DOI: 10.1007/s11886-020-01290-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF THE REVIEW Low- and middle-income countries (LMICs) have long-battled communicable diseases, and now, a rise in non-communicable diseases (NCD) is conferring tremendous burden in these areas. Cardiovascular disease (CVD) remains the number one cause of death among NCDs across the globe. The current review provides insight regarding this disease burden and highlights challenges as well as strategies for establishing functional cardiac surgery centers and sustainable access to comprehensive cardiovascular care within LMICs. RECENT FINDINGS Without effective prevention and treatment strategies, estimates suggest that deaths from CVDs will reach 24 million by the year 2030. Surgery exists as a limited option for selected patients with advanced cardiac disease in LMICs in comparison with its availability in developed countries. Multi-lateral or public-private initiatives, government investment, philanthropic efforts, innovative financing systems to strengthen Universal Health Coverage, and expansion of training options through centers of excellence appear to be the way forward to broadening the availability of cardiovascular services, inclusive of surgery, to LMICs.
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Affiliation(s)
- Samuel Byiringiro
- School of Nursing, The Johns Hopkins University, 525 North Wolfe St., Baltimore, MD, USA.
| | | | | | | | - JaBaris Swain
- Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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7
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Effect of anaemia on the diagnosis of rheumatic heart disease using World Heart Federation criteria. Cardiol Young 2019; 29:862-868. [PMID: 31218969 DOI: 10.1017/s1047951119000404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is overlap between pathological mitral regurgitation seen in borderline rheumatic heart disease using World Heart Federation echocardiography criteria and physiologic regurgitation found in normal children. One possible contributing factor is higher rates of anaemia in endemic countries. OBJECTIVE To investigate the contribution of anaemia as a potential confounder in the diagnosis of rheumatic heart disease detected in echocardiographic screening. METHOD/DESIGN A novel Server 2012 data warehouse tool was used to incorporate haematology and echocardiography databases. The study included a convenience sample of patients from 5 to 18 years old without structural or functional heart disease that had a haemoglobin value within 1 month prior to an echocardiogram. Echocardiogram images were reviewed to determine presence or absence of World Heart Federation criteria for rheumatic heart disease. The rate of rheumatic heart disease among anaemic and non-anaemic children according to gender- and age-based norms groups was compared. RESULTS Of the 935 patients who met the study inclusion criteria, 406 were classified as anaemic. There was no difference in the rate of echocardiograms meeting criteria for borderline rheumatic heart disease in anaemic (2.0%, 95% CI 0.6-3.3%) and non-anaemic children (1.3%, 95% CI 0.3-2.3%). However, there was a statistically significant increase in rates of mitral regurgitation of unclear significance among anaemic versus non-anaemic patients (8.6 versus 3.6%; p = 0.0012). CONCLUSION Anaemia does not increase the likelihood of meeting echocardiographic criteria for borderline rheumatic heart disease. Future studies should evaluate for the correlation between anaemia and mitral regurgitation in endemic settings.
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Zilla P, Bolman RM, Yacoub MH, Beyersdorf F, Sliwa K, Zühlke L, Higgins RS, Mayosi B, Carpentier A, Williams D. The Cape Town Declaration on access to cardiac surgery in the developing world. J Thorac Cardiovasc Surg 2018; 156:2206-2209. [DOI: 10.1016/j.jtcvs.2018.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zilla P, Bolman RM, Yacoub MH, Beyersdorf F, Sliwa K, Zühlke L, Higgins RS, Mayosi B, Carpentier A, Williams D. The Cape Town Declaration on Access to Cardiac Surgery in the Developing World. Ann Thorac Surg 2018; 106:930-933. [DOI: 10.1016/j.athoracsur.2018.05.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 05/28/2018] [Indexed: 10/28/2022]
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Rheumatic Heart Disease Worldwide. J Am Coll Cardiol 2018; 72:1397-1416. [DOI: 10.1016/j.jacc.2018.06.063] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/13/2018] [Accepted: 06/15/2018] [Indexed: 11/19/2022]
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Zilla P, Bolman RM, Yacoub MH, Beyersdorf F, Sliwa K, Zühlke L, Higgins RSD, Mayosi B, Carpentier A, Williams D. The Cape Town declaration on access to cardiac surgery in the developing world. Eur J Cardiothorac Surg 2018; 54:407-410. [DOI: 10.1093/ejcts/ezy272] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peter Zilla
- Christiaan Barnard Division of Cardiothoracic Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - R Morton Bolman
- Division of Cardiothoracic Surgery, University of Vermont, Burlington, VT, USA
| | | | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, Universitäts-Herzzentrum Freiburg–Bad Krotzingen, Freiburg, Germany
| | - Karen Sliwa
- Hatter Institute of Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Liesl Zühlke
- Division of Pediatric Cardiology, Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | | | - Bongani Mayosi
- Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - David Williams
- Wake Forest Institute of Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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12
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Zilla P, Bolman RM, Yacoub MH, Beyersdorf F, Sliwa K, Zühlke L, Higgins RSD, Mayosi B, Carpentier A, Williams D. The Cape Town Declaration on Access to Cardiac Surgery in the Developing World. Asian Cardiovasc Thorac Ann 2018; 26:535-539. [DOI: 10.1177/0218492318791359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Peter Zilla
- Christiaan Barnard Division of Cardiothoracic Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - R Morton Bolman
- Division of Cardiothoracic Surgery, University of Vermont, Burlington, Vermont
| | | | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, Universitäts-Herzzentrum Freiburg–Bad Krotzingen, Freiburg, Germany
| | - Karen Sliwa
- Hatter Institute of Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Liesl Zühlke
- Division of Pediatric Cardiology, Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | | | - Bongani Mayosi
- Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - David Williams
- Wake Forest Institute of Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
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13
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Zilla P, Bolman RM, Yacoub MH, Beyersdorf F, Sliwa K, Zühlke L, Higgins RS, Mayosi BM, Carpentier A, Williams D. The Cape Town Declaration on Access to Cardiac Surgery in the Developing World. Cardiovasc J Afr 2018; 29:256-259. [PMID: 30080213 PMCID: PMC6291809 DOI: 10.5830/cvja-2018-046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Mission to urge all relevant entities within the international cardiac surgery, industry and government sectors to commit to develop and implement an effective strategy to address the scourge of rheumatic heart disease in the developing world through increased access to life-saving cardiac surgery.
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Affiliation(s)
- P Zilla
- Christiaan Barnard Division of Cardiothoracic Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - R Morton Bolman
- Division of Cardiothoracic Surgery, University of Vermont, Burlington, Vermont, USA
| | | | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, Universitäts- Herzzentrum Freiburg-Bad Krotzingen, Freiburg, Germany
| | - Karen Sliwa
- Hatter Institute of Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Liesl Zühlke
- Division of Paediatric Cardiology, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Robert S Higgins
- Department of Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Bongani M Mayosi
- Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - David Williams
- Wake Forest Institute of Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Dougherty S, Beaton A, Nascimento BR, Zühlke LJ, Khorsandi M, Wilson N. Prevention and control of rheumatic heart disease: Overcoming core challenges in resource-poor environments. Ann Pediatr Cardiol 2018; 11:68-78. [PMID: 29440834 PMCID: PMC5803981 DOI: 10.4103/apc.apc_135_17] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rheumatic heart disease (RHD) has long receded as a significant threat to public health in high-income countries. In low-resource settings, however, the specter of RHD remains unabated, as exemplified by recent data from the Global Burden of Diseases Study. There are many complex reasons for this ongoing global disparity, including inadequate data on disease burden, challenges in effective advocacy, ongoing poverty and inequality, and weak health systems, most of which predominantly affect developing nations. In this review, we discuss how each of these acts as a core challenge in RHD prevention and control. We then examine key lessons learnt from successful control programs in the past and highlight resources that have been developed to help create strong national RHD control programs.
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Affiliation(s)
- Scott Dougherty
- Department of Internal Medicine, Ministry of Health, Belau National Hospital, Koror, Republic of Palau
| | - Andrea Beaton
- Children's National Medical Center, Cardiology, Washington DC, USA
| | - Bruno R Nascimento
- Telehealth Center, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, South Africa
| | - Liesl J Zühlke
- Divisions of Paediatric Cardiology and Cardiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Maziar Khorsandi
- Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Nigel Wilson
- Green Lane Paediatic and Congenital Cardiology Department, Starship Children's Hospital, Auckland, New Zealand.,Department of Paediatrics, University of Auckland, Auckland, New Zealand
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Wyber R, Katzenellenbogen JM, Pearson G, Gannon M. The rationale for action to end new cases of rheumatic heart disease in Australia. Med J Aust 2017; 207:322-323. [DOI: 10.5694/mja17.00246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/05/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Rosemary Wyber
- Telethon Kids Institute, University of Western Australia, Perth, WA
| | - Judith M Katzenellenbogen
- Telethon Kids Institute, University of Western Australia, Perth, WA
- Western Australian Centre for Rural Health, University of Western Australia, Perth, WA
| | - Glenn Pearson
- Telethon Kids Institute, University of Western Australia, Perth, WA
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Palafox B, Mocumbi AO, Kumar RK, Ali SKM, Kennedy E, Haileamlak A, Watkins D, Petricca K, Wyber R, Timeon P, Mwangi J. The WHF Roadmap for Reducing CV Morbidity and Mortality Through Prevention and Control of RHD. Glob Heart 2017; 12:47-62. [PMID: 28336386 DOI: 10.1016/j.gheart.2016.12.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 12/01/2016] [Indexed: 10/19/2022] Open
Abstract
Rheumatic heart disease (RHD) is a preventable non-communicable condition that disproportionately affects the world's poorest and most vulnerable. The World Heart Federation Roadmap for improved RHD control is a resource designed to help a variety of stakeholders raise the profile of RHD nationally and globally, and provide a framework to guide and support the strengthening of national, regional and global RHD control efforts. The Roadmap identifies the barriers that limit access to and uptake of proven interventions for the prevention and control of RHD. It also highlights a variety of established and promising solutions that may be used to overcome these barriers. As a general guide, the Roadmap is meant to serve as the foundation for the development of tailored plans of action to improve RHD control in specific contexts.
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Affiliation(s)
- Benjamin Palafox
- ECOHOST -The Centre for Health and Social Change, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | - Ana Olga Mocumbi
- Instituto Nacional de Saúde, Ministério da Saúde and Universidade Eduardo Mondlane, Maputo, Moçambique
| | - R Krishna Kumar
- Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
| | - Sulafa K M Ali
- University of Khartoum and Sudan Heart Center, Khartoum, Sudan
| | - Elizabeth Kennedy
- Fiji RHD Prevention and Control Project, Ministry of Health and Medical Services and Cure Kids New Zealand, Suva, Fiji
| | | | - David Watkins
- Department of Medicine, University of Washington, Seattle, WA, USA; Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Kadia Petricca
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rosemary Wyber
- Telethon Kids Institute, Perth, Western Australia, Australia
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Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease: Epidemiology and Clinical Considerations. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2017; 19:15. [PMID: 28285457 PMCID: PMC5346434 DOI: 10.1007/s11936-017-0513-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OPINION STATEMENT Early recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-to-high risk populations. Initiation of secondary prophylaxis and the establishment of early medium to long-term care plans is a key aspect of the management of ARF. It is a requirement to identify high-risk individuals with RHD such as those with heart failure, pregnant women, and those with severe disease and multiple valve involvement. As penicillin is the mainstay of primary and secondary prevention, further research into penicillin supply chains, alternate preparations and modes of delivery is required.
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18
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Gemechu T, Mahmoud H, Parry EHO, Phillips DIW, Yacoub MH. Community-based prevalence study of rheumatic heart disease in rural Ethiopia. Eur J Prev Cardiol 2017; 24:717-723. [DOI: 10.1177/2047487316687104] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | | | - Magdi H Yacoub
- Aswan Heart Centre, Aswan, Egypt
- NHLI, Heart Science Centre, Imperial College London, UK
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