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To determine the ability to accurately diagnose acute rheumatic fever given the resources available at three levels of the Ugandan healthcare system.
Rheumatic heart disease is a major cause of premature cardiovascular morbidity and mortality globally. Over the past decade, echocardiographic screening has changed our understanding of the natural history of RHD, revealing a high burden of clinically silent, mild RHD among people who cannot recall a history of preceding acute rheumatic fever. This viewpoint outlines the evidence that this earliest form of rheumatic heart disease, only detectable through echocardiographic screening, is an intermediate stage that many, but not all, individuals may pass through on the pathway to advanced rheumatic heart disease.
Rheumatic heart disease remains a major public health challenge in Ethiopia, particularly among children. Monthly intramuscular benzathine penicillin G is the cornerstone of secondary prophylaxis, yet adherence and delivery are suboptimal. This study explores the lived experiences of children and adolescents with RHD, capturing their direct voices and those of their caregivers to understand determinants of secondary prophylaxis uptake.
Rheumatic heart disease (RHD) is the acquired autoimmune heart valve damage resulting from untreated infection with the Streptococcus pyogenes bacterium, which affects people experiencing socioeconomic disadvantage globally. This study measured RHD-associated major adverse cardiovascular events (MACE) and the increased risk associated with pregnancy among women diagnosed with RHD.
Jonathan Carapetis AM AM MBBS FRACP FAFPHM PhD FAHMS Co-Head, Strep A Translation; Co-Founder of REACH 08 6319 1000 contact@thekids.org.au Head,
Streptococcus pyogenes, or group A Streptococcus (GAS), infections contribute to a high burden of disease in Aboriginal Australians, causing skin infections and immune sequelae such as rheumatic heart disease. Controlling skin infections in these populations has proven difficult, with transmission dynamics being poorly understood. We aimed to identify the relative contributions of impetigo and asymptomatic throat carriage to GAS transmission.
Jonathan Carapetis AM AM MBBS FRACP FAFPHM PhD FAHMS Co-Head, Strep A Translation; Co-Founder of REACH 08 6319 1000 contact@thekids.org.au Head,
Regular intramuscular benzathine penicillin G injections have been the cornerstone of rheumatic heart disease (RHD) secondary prophylaxis since the 1950s. As the pharmacological correlate of protection remains unknown, it is difficult to recommend changes to this established regimen. Determining the minimum effective penicillin exposure required to prevent Streptococcus pyogenes infection will accelerate development of new long-acting penicillins for RHD prevention as well as inform opportunities to improve existing regimens. The CHIPS trial will address this knowledge gap by directly testing protection afforded by different steady state plasma concentrations of penicillin in an established model of experimental human S. pyogenes pharyngitis.
The impact of mitral regurgitation from pediatric rheumatic heart disease and its effect on left ventricular remodeling and function following surgical intervention is uncertain. The objective is to explore the impact of mitral valve surgeries on myocardial mechanics, remodeling and function and identify pre-operative predictors of post-operative dysfunction which may contribute to the optimal timing of intervention.
In the 21st century, rheumatic fever (RF) and rheumatic heart disease (RHD) are neglected diseases of marginalized communities.