The “Cairo Accord”- Towards the Eradication of RHD: An Update

Kotit, Susy; Phillips, David I. W.; Afifi, Ahmed; Yacoub, Magdi H.

doi:10.3389/fcvm.2021.690227

Cited by 9 publications

(6 citation statements)

References 83 publications

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“…Also the survey data were unable to predict which subjects had continuing or progressive disease. In addition, as has been reported widely [ 9 , 10 ] there was considerable heterogeneity of the echocardiographic appearances over the course of the study with evidence of both progression and regression of valve lesions and the appearance of new disease in 8% of people who had normal echocardiograms during the initial screening.…”

Section: Discussionmentioning

confidence: 71%

Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up

et al. 2021

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Background As little is known about the prevalence and clinical progression of subclinical (latent) rheumatic heart disease (RHD) in sub-Saharan Africa, we report the results of a 5 year follow-up of a community based, echocardiographic study of the disease, originally carried out in a rural area around Jimma, Ethiopia. Methods Individuals with evidence of RHD detected during the baseline study as well as controls and their family members were screened with a short questionnaire together with transthoracic echocardiography. Results Of 56 individuals with RHD (37 definite and 19 borderline) in the original study, 36 (26 definite and 10 borderline) were successfully located 57.3 (range 44.9–70.7) months later. At follow-up two thirds of the definite cases still had definite disease; while a third had regressed. Approximately equal numbers of the borderline cases had progressed and regressed. Features of RHD had appeared in 5 of the 60 controls. There was an increased risk of RHD in the family relatives of borderline and definite cases (3.8 and 4.0 times respectively), notably among siblings. Compliance with penicillin prophylaxis was very poor. Conclusions We show the persistence of echocardiographically demonstrable RHD in a rural sub-Saharan population. Both progression and regression of the disease were found; however, the majority of the individuals who had definite features of RHD had evidence of continuing RHD lesions five years later. There was an increased risk of RHD in the family relatives of borderline and definite cases, notably among siblings. The findings highlight the problems faced in addressing the problem of RHD in the rural areas of sub-Saharan Africa. They add to the evidence that community-based interventions for RHD will be required, together with appropriate ways of identifying active disease, achieving adequate penicillin prophylaxis and developing vaccines for primary prevention.

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Section: Discussionmentioning

confidence: 71%

Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up

et al. 2021

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“…There is a pressing need for specialized centers for the treatment of rheumatic heart valve disease where hospitals and surgeons, and volume of cases would increase the likelihood of a successful, durable, and, importantly, reproducible repair (25,26). It is also critical to enhance facilities for postoperative follow-up of patients in terms of medical treatment, anticoagulation, ventricular function, and, importantly, quality of life.…”

Section: Conclusion and Future Directionmentioning

confidence: 99%

Expanding Valve Repair in Rheumatic Heart Disease

Afifi

Shehata

Nagi

et al. 2022

Front. Cardiovasc. Med.

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Rheumatic heart disease is a serious ailment with significant morbidity and mortality in endemic areas; yet, there is no agreement on indication, timing, and surgical modality for treating rheumatic valve affection. There is mounting evidence that rheumatic mitral valve repair is possible with good long-term results, less is the case with rheumatic aortic valve disease. We discuss the surgical approach for both valves emphasizing the role of multimodality imaging.

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“…Development of databases for accurate data on epidemiology and natural disease history is vital for the prevention and control of RHD, as recommended in the Cairo Accord aiming at disease eradication ( 15 ). Comparing the results of different regional registries and the main causative factors, including the influence of genetics and epigenetics should help the global efforts to eradicate RHD ( 16 , 17 ).…”

Section: Introduction and Rationale For The Studymentioning

confidence: 99%

The Aswan Rheumatic heart disease reGIstry: rationale and preliminary results of the ARGI database

Kotit,

Yacoub

2023

Front. Cardiovasc. Med.

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BackgroundRheumatic Heart Disease (RHD) remains a major cause of valvular heart disease related mortality and morbidity in low- and middle-income countries, with significant variation in characteristics and course of the disease across different regions. However, despite the high disease burden, there is sparse region-specific data on demographics, disease characteristics and course in treated and untreated patients to guide policy.MethodsThe ARGI database is a hospital-based registry in a tertiary referral national centre (Aswan Heart Centre, AHC) in which all patients with the diagnosis of RHD are being included. The mode of presentation, including baseline clinical and echocardiographic characteristics (as well as other imaging modalities), biomarkers and genetics are being documented. Treatment modalities and adherence to treatment is being recorded and patients are followed up regularly every 6 and/or 12 months, or more frequently if needed.DiscussionThis study shows for the first time an in-depth analysis of the severity and phenotype of disease in Egyptian patients presenting with RHD as well as the progression with time and provides a platform for further comparisons of regional differences in these details as well as their causes. The ARGI database will be of help in achieving the objectives of the Cairo Accord aiming at eradication of RF and RHD.

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The “Cairo Accord”- Towards the Eradication of RHD: An Update

Cited by 9 publications

References 83 publications

Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up

Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up

Expanding Valve Repair in Rheumatic Heart Disease

The Aswan Rheumatic heart disease reGIstry: rationale and preliminary results of the ARGI database

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