Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study)

Zühlke, Liesl; Engel, Mark E; Karthikeyan, Ganesan; Rangarajan, Sumathy; Mackie, Pam; Cupido, Blanche; Mauff, Katya; Islam, Shofiqul; Joachim, Alexia; Daniels, Rezeen; Francis, Veronica; Ogendo, Stephen; Gitura, Bernard; Mondo, Charles; Okello, Emmy; Lwabi, Peter; Al-Kebsi, Mohammed; Hugo-Hamman, Christopher; Sheta, Sahar; Haileamlak, Abraham; Daniel, Wandimu; Goshu, Dejuma Yadeta; Abdissa, Senbeta Guteta; Desta, Araya G.; Shasho, Bekele A.; Begna, Dufera M.; ElSayed, Ahmed; Ibrahim, Ahmed S.; Musuku, John; Bode‐Thomas, Fidelia; Okeahialam, Basil N; Ige, Olukemi; Sutton, Christopher; Misra, Rajeev; Fadl, Azza Abul; Kennedy, Neil; Damasceno, Albertino; Sani, Mahmoud U; Ogah, Okechukwu S; Olunuga, Taiwo; Elhassan, Huda H M; Mocumbi, Ana Olga; Adeoye, Abiodun M.; Mntla, Pindile; Ojji, Dike; Mucumbitsi, Joseph; Teo, Koon; Yusuf, Salim; Mayosi, Bongani M.

doi:10.1093/eurheartj/ehu449

Cited by 446 publications

(428 citation statements)

References 29 publications

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“…The important prevalence of rheumatic heart disease in many developing countries alters the necessary mix of resources and therapy to address the cardiac needs of the young population. 147,148 Countries such as India and China are in a rapid phase of proliferation of services capable of providing advanced cardiovascular care for children, and in each of these countries, cadres of locally and internationally trained senior physicians and surgeons are leading programs that are both providing clinical services and training younger generations of clinical providers. International support for congenital cardiac services has evolved beyond the scope of medical missions and exchange programs for training, and now includes successful multinational programs to report clinical outcomes with reference to global benchmarks and to enhance those outcomes using quality improvement practice.…”

Section: Global Burden Of Chdmentioning

confidence: 99%

Trends in Congenital Heart Disease

2016

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Section: Global Burden Of Chdmentioning

confidence: 99%

Trends in Congenital Heart Disease

2016

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“…[7][8][9][10][11][12][13][14] In addition, Kenya has a high burden of rheumatic heart disease, [15][16][17] and it is likely that streptococcal pharyngitis and acute rheumatic fever are underdiagnosed in febrile patients, though it is unclear whether these patients are presenting to a provider for care.…”

Section: Introductionmentioning

confidence: 99%

Etiology of Pediatric Fever in Western Kenya: A Case–Control Study of Falciparum Malaria, Respiratory Viruses, and Streptococcal Pharyngitis

O’Meara¹,

Mott²,

Laktabai³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. In Kenya, more than 10 million episodes of acute febrile illness are treated annually among children under 5 years. Most are clinically managed as malaria without parasitological confirmation. There is an unmet need to describe pathogen-specific etiologies of fever. We enrolled 370 febrile children and 184 healthy controls. We report demographic and clinical characteristics of patients with Plasmodium falciparum, group A streptococcal (GAS) pharyngitis, and respiratory viruses (influenza A and B, respiratory syncytial virus [RSV], parainfluenza [PIV] types 1-3, adenovirus, human metapneumovirus [hMPV]), as well as those with undifferentiated fever. Of febrile children, 79.7% were treated for malaria. However, P. falciparum was detected infrequently in both cases and controls (14/268 [5.2%] versus 3/133 [2.3%], P = 0.165), whereas 41% (117/282) of febrile children had a respiratory viral infection, compared with 24.8% (29/117) of controls (P = 0.002). Only 9/515 (1.7%) children had streptococcal infection. Of febrile children, 22/269 (8.2%) were infected with 1 pathogen, and 102/275 (37.1%) had fevers of unknown etiology. Respiratory viruses were common in both groups, but only influenza or parainfluenza was more likely to be associated with symptomatic disease (attributable fraction [AF] 67.5% and 59%, respectively). Malaria was overdiagnosed and overtreated. Few children presented to the hospital with GAS pharyngitis. An enhanced understanding of carriage of common pathogens, improved diagnostic capacity, and better-informed clinical algorithms for febrile illness are needed.

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“…We are continuing to conduct research to enable a deeper understanding of the pathogenesis of RHD and thus devise evidence based interventional approaches. [20][21][22] Unfortunately, these are expensive endeavors which require governmental involvement and support, yet there is currently no government policy on the prevention and control of RF/ RHD in Uganda.…”

Section: Patterns Of Different Treatment Modality Of Patients Inmentioning

confidence: 99%

Proportion of patients in the Uganda rheumatic heart disease registry with advanced disease requiring urgent surgical interventions

Zhang¹,

Okello²,

Nyakoojo³

et al. 2016

Afr H. Sci.

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Abstract:Introduction: Since the establishment of the Uganda Rheumatic Heart Registry, over 900 patients have been enrolled. We sought to stratify the patients in the registry according to disease severity and optimal management strategy. Methods: We reviewed data of 618 patients who had enrolled in the Registry between March 2010 and February 2013. The 67 patients who had died were excluded leaving 551 patients who were recruited. The optimum management strategy was determined according to the 2012 European Society of Cardiology guidelines on the management of valvular heart disease. Results: Out of the 551 patient's records evaluated, 398 (72.3%) required invasive intervention, with 332(60.3%) patients requiring surgery and 66 (12.0%) requiring percutaneous mitral commissurotomy (PMC). This leaves only 27.7% of patients who required only medical management. Currently, majority of the patients (498, 90.4%) in the registry are on medical treatment. Of the 60.3% requiring surgical intervention, only 8.0% (44 patients) underwent valvular surgery and 5(1.0%) patients of the 66 (12.0%) underwent PMC successfully. Conclusion: There is a high proportion of patients with severe disease that require surgical treatment yet they cannot access this therapy due to absence of local expertise.

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Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study)

Cited by 446 publications

References 29 publications

Trends in Congenital Heart Disease

Trends in Congenital Heart Disease

Etiology of Pediatric Fever in Western Kenya: A Case–Control Study of Falciparum Malaria, Respiratory Viruses, and Streptococcal Pharyngitis

Proportion of patients in the Uganda rheumatic heart disease registry with advanced disease requiring urgent surgical interventions

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