A New Avenue For Controlling Rheumatic Heart Disease?
Rheumatic heart disease (RHD) is the most important cause of acquired cardiovascular disease in children and young adults and the most common cause of multivalvular disease in low- and middle-income countries (LMICs). Over the past several decades, the rheumatic fever (RF) and RHD burdens have grown especially pronounced in developing countries, which now account for over 80% of all cases.
There are strong pragmatic and humanitarian reasons for investing in measures to reduce the prevalence and premature mortality of RHD. By even the most conservative estimates, more than 15.6 million people globally suffer from RHD and 233,000 die prematurely of the disease every year, prompting the World Heart Federation to set a worldwide goal to reduce by 25% premature deaths from RF and RHD among individuals aged less than 25 years by 2025. To achieve this target globally, nationally and locally, a clear roadmap is needed.
Previous work in Asia has estimated a current RHD burden of around 10.8-15.9 million patients, leading to a staggering 356,000 to 524,000 deaths per year. However, epidemiological data remain sparse and inconsistent, and only a handful of studies have reported on the prevalence of the disease in South-East Asia specifically
Toward filling this gap, a research team led by the NCD Asia Pacific Alliance including experts from the University of Tokyo, the Telethon Kids Institute of the University of Western Australia the Department of Cardiology and Vascular Medicine of the University of Indonesia, and Freeport Public Health and Malaria Control of International SOS analyzed data from a large cohort in Papua, Indonesia. Analyses revealed that RF and RHD remain major health issues into adulthood, with mitral stenosis being the most common valvular lesion. The work also determined that the cumulative RHD risk was significantly higher among older age groups.
Professor Jonathan Carapetis, Director of the Telethon Kids Institute and global RHD expert, told the NCD Asia Pacific Alliance, “We are increasingly aware of the morbidity and premature mortality due to RHD around the world, but data from South East Asia have been thin on the ground.”
“This study confirms that RHD is just as common in South East Asia as in other resource-poor settings,” Professor Carapetis explained. “The long delay before presenting with RHD raises the possibility that echocardiographic screening, potentially at the time of employment, could permit preventive measures such as secondary prophylaxis to improve clinical outcomes. By taking an occupational health approach to RHD, this study opens up a new avenue for controlling this disease.”
For more on the Telethon Kids Institute, click here.
The original research can be found here: http://heartasia.bmj.com/content/7/2/44.full