Browsing by Subject "Rheumatic fever"

Now showing 1 - 9 of 9
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    A proposal for the eradication of rheumatic fever in our lifetime
    (2006) Mayosi, Bongani M
    The Pan African Society of Cardiology (PASCAR) convened the 1st All Africa Workshop on Rheumatic Fever (RF) and Rheumatic Heart Disease (RHD) on 15 - 16 October 2005 at the Champagne Sports Resort, Drakensberg, South Africa. The purpose of the Workshop was to formulate an action plan for the prevention of RF and RHD in Africa. The gathering was a response to the new guideline on the control of RF and RHD by the World Health Organization (WHO) in 2004.1 The meeting (and this supplement) was made possible by the generous sponsorship of the national Department of Health of South Africa, the Medical Research Council of South Africa, the WHO Regional Office for Africa (WHO-AFRO) and the World Heart Federation, and endorsed by the Heart Foundation of South Africa, the Paediatric Cardiac Society of South Africa, and the South African Heart Association. The other organisations represented at the meeting included the Africa Heart Network, the Nigerian Heart Foundation, and academics from the universities of Alexandria, Cape Town, Ghana, Ibadan, KwaZulu-Natal, Libreville, Limpopo, Nairobi, Pretoria, and Eduardo Mondlane University.
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    Antigenic mimicry and autoantibodies in rheumatic fever
    (1990) Eichbaum, Quentin Gavin
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    Genetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studies
    (Public Library of Science, 2011) Engel, Mark E; Stander, Raphaella; Vogel, Jonathan; Adeyemo, Adebowale A; Mayosi, Bongani M
    BACKGROUND: Acute rheumatic fever is considered to be a heritable condition, but the magnitude of the genetic effect is unknown. The objective of this study was to conduct a systematic review and meta-analysis of twin studies of concordance of acute rheumatic fever in order to derive quantitative estimates of the size of the genetic effect. METHODS: We searched PubMed/MEDLINE, ISI Web of Science, EMBASE, and Google Scholar from their inception to 31 January 2011, and bibliographies of retrieved articles, for twin studies of the concordance for acute rheumatic fever or rheumatic heart disease in monozygotic versus dizygotic twins that used accepted diagnostic criteria for acute rheumatic fever and zygosity without age, gender or language restrictions. Twin similarity was measured by probandwise concordance rate and odds ratio (OR), and aggregate probandwise concordance risk was calculated by combining raw data from each study. ORs from separate studies were combined by random-effects meta-analysis to evaluate association between zygosity status and concordance. Heritability was estimated by fitting a variance components model to the data. RESULTS: 435 twin pairs from six independent studies met the inclusion criteria. The pooled probandwise concordance risk for acute rheumatic fever was 44% in monozygotic twins and 12% in dizygotic twins, and the association between zygosity and concordance was strong (OR 6.39; 95% confidence interval, 3.39 to 12.06; P<0.001), with no significant study heterogeneity (P = 0.768). The estimated heritability across all the studies was 60%. CONCLUSIONS: Acute rheumatic fever is an autoimmune disorder with a high heritability. The discovery of all genetic susceptibility loci through whole genome scanning may provide a clinically useful genetic risk prediction tool for acute rheumatic fever and its sequel, rheumatic heart disease.
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    Health system costs of rheumatic heart disease care in South Africa
    (2021-07-03) Hellebo, Assegid G.; Zuhlke, Liesl J.; Watkins, David A.; Alaba, Olufunke
    Background Rheumatic Heart Disease (RHD) is a disease of poverty that is neglected in developing countries, including South Africa. Lack of adequate evidence regarding the cost of RHD care has hindered national and international actions to prevent RHD related deaths. The objective of this study was to estimate the cost of RHD-related health services in a tertiary hospital in the Western Cape, South Africa. Methods The primary data on service utilisation were collected from a randomly selected sample of 100 patient medical records from the Global Rheumatic Heart Disease Registry (the REMEDY study) - a registry of individuals living with RHD. Patient-level clinical data, including, prices and quantities of medications and laboratory tests, were collected from the main tertiary hospital providing RHD care. All annual costs from a health system perspective were estimated in 2017 (base year) in South African Rand (ZAR) using a combination of ingredients and step-down costing approaches and later converted to United States dollars (USD). Step-down costing was used to estimate provider time costs and all other facility costs such as overheads. A 3% discount rate was also employed in order to allow depreciation and opportunity cost. We aggregated data to estimate the total annual costs and the average annual per-patient cost of RHD and conducted a one-way sensitivity analysis. Results The estimated total cost of RHD care at the tertiary hospital was USD 2 million (in 2017 USD) for the year 2017, with surgery costs accounting for 65%. Per-patient, average annual costs were USD 3900. For the subset of costs estimated using the ingredients approach, outpatient medications, and consumables related to cardiac catheterisation and heart valve surgery were the main cost drivers. Conclusions RHD-related healthcare consumes significant tertiary hospital resources in South Africa, with annual per-patient costs higher than many other non-communicable and infectious diseases. This analysis supports the scaling up of primary and secondary prevention programmes at primary health centers in order to reduce future tertiary care costs. The study could also inform resource allocation efforts and provide cost estimates for future studies of intervention cost-effectiveness.
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    Notification of rheumatic fever in South Africa - evidence for underreporting by health care professionals and administrators
    (2006) Nkgudi, Boitumelo; Robertson, Kate A; Volmink, Jimmy; Mayosi, Bongani M
    Objective. To determine whether under-reporting of rheumatic fever occurs at hospital, municipal, provincial and national levels of the South African health system. Background. Information on the incidence of rheumatic fever (RF) and the prevalence of rheumatic heart disease (RHD) is required for the prevention of valvular heart disease in developing countries. In South Africa, RF was made a notifiable condition in 1989. It has recently been suggested that the reporting of RF cases may be incomplete, possibly because of underreporting by health care professionals and deficient administration of the disease notification system in South Africa. Method and results. We assessed whether underreporting of RF cases occurs by comparing the numbers of RF cases reported per year at hospital, municipal, provincial and national levels from 1990 to 2004. There was a fall in the number of RF cases reported per year at national and provincial level over the 15 years of observation. A detailed analysis of the number of RF cases reported at hospital, municipal and provincial level for a 5-year period showed that more cases were diagnosed in one hospital (serving a smaller population) than were captured at municipal and provincial level (serving a larger population), suggesting underreporting by health care professionals. There were discrepancies in the number of cases reported at municipal, provincial and national level, suggesting poor administration of the notification system. Conclusion. There appears to be underreporting of RF cases by health care professionals, and poor administration of the RF notification system. Health care professionals need to be educated about the statutory requirement to notify all RF cases in South Africa. An effective national disease notification system is required.
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    Prevalence of rheumatic heart disease in Zambian school children
    (BioMed Central, 2018-07-03) Schwaninger, Sherri; Musuku, John; Engel, Mark E; Musonda, Patrick; Lungu, Joyce C; Machila, Elizabeth; Mtaja, Agnes; Mulendele, Evans; Kavindele, Dorothy; Spector, Jonathan; Tadmor, Brigitta; Gutierrez, Marcelo M; Van Dam, Joris; Colin, Laurence; Long, Aidan; Fishman, Mark C; Mayosi, Bongani M; Zühlke, Liesl J
    Background The large global burden of rheumatic heart disease (RHD) has come to light in recent years following robust epidemiologic studies. As an operational research component of a broad program aimed at primary and secondary prevention of RHD, we sought to determine the current prevalence of RHD in the country’s capital, Lusaka, using a modern imaging-based screening methodology. In addition, we wished to evaluate the practicality of training local radiographers in echocardiography screening methods. Methods Echocardiography was conducted on a random sample of students in 15 schools utilizing a previously validated, abbreviated screening protocol. Through a task-shifting scheme, and in the spirit of capacity-building to enhance local diagnostic and research skills, general radiographers based at Lusaka University Teaching Hospital (UTH) were newly trained to use portable echocardiography devices. Students deemed as screen-positive were referred for comprehensive echocardiography and clinical examination at UTH. Cardiac abnormalities were classified according to standard World Heart Federation criteria. Results Of 1102 students that were consented and screened, 53 students were referred for confirmatory echocardiography. Three students had definite RHD, 10 had borderline RHD, 29 were normal, and 11 students were lost to follow-up. The rates of definite, borderline, and total RHD were 2.7 per 1000, 9.1 per 1000, and 11.8 per 1000, respectively. Anterior mitral valve leaflet thickening and chordal thickening were the most common morphological defects. The pairwise kappa test showed fair agreement between the local radiographers and an echocardiographer quality assurance specialist. Conclusion The prevalence of asymptomatic RHD in urban communities in Zambia is within the range of results reported in other sub-Saharan African countries using the WHF criteria. Task-shifting local radiographers to conduct echocardiography was feasible. The results of this study will be used to inform ongoing efforts in Zambia to control and eventually eliminate RHD. Trial registration The study was registered on clinicaltrials.gov ( #NCT02661763 ).
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    Protocols for antibiotic use in primary and secondary prevention of rheumatic fever
    (2006) Mayosi, Bongani M
    Several guidelines and studies that address the issue of ‘best practice’ in the primary and secondary prevention of rheumatic fever (RF) have been published recently.1-4 Here I present a summary of the latest recommendations for the prevention of RF that have been distilled from these sources.
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    The Drakensberg Declaration on the Control of Rheumatic Fever and Rheumatic Heart Disease in Africa
    (2006) Mayosi, Bongani; Robertson, Kate; Volmink, Jimmy; Adebo, Wole; Akinyore, Kingsley; Amoah, Albert; Bannerman, Charles; Biesman-Simons, Shan; Jonathan, Carapetis; Cilliers, Antoinette; Commerford, Patrick; Croasdale, Anne; Damasceno, Albertino; Dean, Jenny; Dean, Michael; de Souza, Robert; Filipe, Antonio; Hugo-Hamman, Chris; JurgensClur, Sally-Ann; Kombila-Koumba, Pierre; Kotzenberg, Christelle; Lawrenson, John; Manga, Pravin; Matenga, Jonathan; Mathivha, Tshimbi; Mntla, Phindile; Mocumbi, Ana; Mokone, Tiny; Ogola, Elijah; Omokhodion, Samuel; Palweni, Chapman; Pearce, Adrian; Salo, Avril; Thomas, Baby; Walker, Kathie; Wiysonge, Charles; Zaher, Salah
    This paper reviews some research studies on tillage methods influencing soil and moisture conservation in the eastern African countries of Kenya, Tanzania, Malawi and Ethiopia during the past four decades. Most of these studies were conducted in marginal rainfall (semi arid ) areas and on shallow soils of various textures (sandy clay loam, sandy clay, clay and loam). The studies were meant to establish the effects of tillage and residue management practices on physico-chemical soil properties (i.e. structure, bulk density, soil moisture and organic matter contents), runoff and infiltration. This review emphasizes the importance of appropriate tillage and residue management methods (contour bunds and terraces, minimum tillage, tied ridging, mulching and conventional tillage) in providing soil conditions favourable for soil moisture conservation and subsequent crop performance and yield on smallholder farms
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    Towards a uniform plan for the control of rheumatic fever and rheumatic heart disease in Africa - the Awareness Surveillance Advocacy Prevention (ASAP) Programme
    (2006) Robertson, Kate A; Volmink, Jimmy A; Mayosi, Bongani M
    Over the last 150 years the developed world has experienced a dramatic decline in the incidence and prevalence of rheumatic fever and rheumatic heart disease (RF/RHD) through improved living conditions and the widespread use of penicillin for the treatment of streptococcal pharyngitis. Despite the proven effectiveness and availability of penicillin for both primary and secondary prevention of RF, developing countries continue to face unacceptably high rates of the disease.1 RF/RHD is the most common cardiovascular disease in children and young adults in the world, because 80% of the world’s population live in developing countries where the disease is still rampant. Recent research estimates that RF/RHD affects about 15.6 million people worldwide, with 282 000 new cases and 233 000 deaths each year. There are 2.4 million affected children between 5 and 14 years of age in developing countries, 1 million of whom live in sub-Saharan Africa, making the continent the major RF/RHD hotspot.2