Clinical Outcomes in 3343 Children and Adults With Rheumatic Heart Disease From 14 Low- and Middle-Income Countries

Zühlke, Liesl; Karthikeyan, Ganesan; Engel, Mark E; Rangarajan, Sumathy; Mackie, Pam; Cupido, Blanche; Islam, Shofiqul; 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; Yilgwan, Christopher; Amusa, Ganiyu; Ige, Olukemi; Okeahialam, Basil N; Sutton, Christopher; Misra, Rajeev; Fadl, Azza Abul; Kennedy, Neil; Damasceno, Albertino; Sani, Mahmoud U; Ogah, Okechukwu S; Elhassan, Taiwo OlunugaHuda H. M.; Mocumbi, Ana Olga; Adeoye, Abiodun M.; Mntla, Phindile; Ojji, Dike; Mucumbitsi, Joseph; Teo, Koon; Yusuf, Salim; Mayosi, Bongani M.

doi:10.1161/circulationaha.116.024769

Cited by 248 publications

(303 citation statements)

References 33 publications

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“…There were more definite RHD cases than borderline RHD cases (20 vs 17) in the study by Engelman. Typically, borderline RHD is three to five times more frequent than definite RHD in screening studies 5 9. This suggests that the cohort reported by Engelman may be an ‘enriched’ population, the result of selection bias due to differential follow-up of patients with borderline and definite RHD.…”

Section: Generalisability Of Resultsmentioning

confidence: 99%

Measuring and reporting disease progression in subclinical rheumatic heart disease: Table 1

Karthikeyan

2016

Heart Asia

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Section: Generalisability Of Resultsmentioning

confidence: 99%

Measuring and reporting disease progression in subclinical rheumatic heart disease: Table 1

Karthikeyan

2016

Heart Asia

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“…Secondary prophylaxis with intramuscular benzathine penicillin is a low-cost treatment with proven efficacy in the prevention of recurrent streptococcal throat infections and valvular injury and in the prevention of community health [18,19]. The effect of secondary prophylaxis on heart failure development or mortality is related to the onset of the prophylaxis at an early stage of the disease [20]. Secondary prophylaxis has been shown to have no effect on heart failure and mortality in Sub-Saharan African countries and in Northern Australia where echocardiographic screening has not been adequately performed and patients have been presented with advanced RHD [21].…”

Section: Discussionmentioning

confidence: 99%

Did we overcome rheumatic heart disease or is it still a public disease burden?

Yıldırım¹,

Buğan²

2017

Med-Science

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Rheumatic heart disease (RHD), affecting approximately 32 million people all over the world is one of the major causes of cardiovascular morbidity and mortality especially in developing countries. In this ongoing pilot study, we aim to investigate the prevalence of both definitive and borderline RHD in Turkey as a developing country. A total of 386 healthy young individuals (45 female, 341 males) who applied to our Cardiology Clinic for being military personnel coming from different regions of Turkey in the year 2015, were recruited for our study. 2012 World Heart Federation (WHF) criteria for echocardiographic assessment and diagnosis of RHD were used. Study population was classified into one of the three groups as normal, borderline RHD and definitive RHD. The three groups were similar in terms of baseline characteristics and laboratory findings. Definitive and borderline RHD were found in 11 (2,9%) and 29 (7,5%) individuals, respectively. Abnormal thickening of the anterior mitral valve leaflet (AMVL) was found statistically significant between the normal and the RHD groups (3.1±0.6 vs 4.2±0.9, p<0.001). Even though the number of patients in our study is small, we found the incidence of borderline and the definitive RHD higher than we expected. Transthoracic echocardiography may be helpful in detecting RHD at the early-stages and preventing progression of the disease with secondary antibiotic prophylaxis.

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“…In this study, 16.9% of patients died within 2 years follow-up. There was a gradient in mortality rates, ranging from 12.8% in upper middle income countries to 20.8% in low income countries 30. Although it was a study based on tertiary care settings, it clearly shows the difficulties in accessing medical management and the severe disease status of patients with RHD in many regions of the world.…”

Section: Is Rhd Not a High Risk Condition?mentioning

confidence: 99%

Interactive clinical case: to give, or not to give, infective endocarditis prophylaxis

Kothari

2017

Heart Asia

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The practice of prophylactic use of antibiotics before certain procedures for preventing infective endocarditis (IE) is not based on rigorous scientific data. It seems reasonable, however, to offer prophylactic antibiotics before dental procedures to patients who would have the highest risk of adverse events if they were to develop IE. The current recommendations do not include patients with rheumatic heart disease (RHD) in such a category. In the real world, however, patients with underlying RHD suffer high morbidity and mortality with IE due to several reasons. Consequently, prophylactic antibiotics should be used judiciously in patients with RHD. Further, other patient related factors might influence the decision to use antibiotics.

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Clinical Outcomes in 3343 Children and Adults With Rheumatic Heart Disease From 14 Low- and Middle-Income Countries

Abstract: Background

Cited by 248 publications

References 33 publications

Measuring and reporting disease progression in subclinical rheumatic heart disease: Table 1

Measuring and reporting disease progression in subclinical rheumatic heart disease: Table 1

Did we overcome rheumatic heart disease or is it still a public disease burden?

Interactive clinical case: to give, or not to give, infective endocarditis prophylaxis

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