The interest in primary prevention for RHD has been recently re-emphasised, and new data are available regarding echocardiographic screening for subclinical RHD and initiation of secondary prevention. Main findings include evidence that the CHD burden is underestimated mainly due to the poor outcome of African children with CHD. We present here an extensive review of recent data from the African continent highlighting key studies and information regarding progress in CHD and RHD since 2005. Zühlke, Liesl Mirabel, Mariana Marijon, EloiĪfrica has one of the highest prevalence of heart diseases in children and young adults, including congenital heart disease (CHD) and rheumatic heart disease ( RHD). More research is required to provide evidence-based recommendations for policy and service design.Ĭongenital heart disease and rheumatic heart disease in Africa: recent advances and current priorities. Strengthening of systems through integration/linkages with other well-performing and resourced services in conjunction with policies to adopt the CCM framework for the secondary and tertiary prevention of RHD in settings with limited resources, has the potential to significantly reduce the burden of RHD globally. Systems strengthening through greater integration of services can improve RHD programs. Further, we illustrate how the Chronic Care Model (CCM), developed for use in non-communicable diseases, offers a relevant framework to approach RHD care. Successes in coronary heart disease control provide inspiration for similarly bold initiatives for RHD. Examining the four-level prevention model (primordial through tertiary prevention) suggests primordial and primary prevention of RHD can leverage off existing tuberculosis control efforts, given shared risk factors. In this narrative review, we describe how RHD care can be informed by and integrated with models of care developed for priority non-communicable diseases (coronary heart disease), and high-burden communicable diseases (tuberculosis). However, RHD is relatively neglected due to the populations involved and its lower incidence relative to other heart diseases. Affected individuals are young and associated morbidity is high. Rheumatic heart disease ( RHD) is a chronic cardiac condition with an infectious aetiology, causing high disease burden in low-income settings. Katzenellenbogen, Judith M Ralph, Anna P Wyber, Rosemary Carapetis, Jonathan R Rheumatic heart disease: infectious disease origin, chronic care approach.
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