Action on Rheumatic Heart Disease What is Rheumatic Heart Disease? Rheumatic heart disease (RHD) is a preventable, treatable disease that affects over 15.6 million people around the world and kills 500,000 of them each year. It afflicts the world’s poorest, most marginalized populations and imposes heavy costs on the health systems that can least afford it. If left untreated, rheumatic heart disease can lead to heart valve damage, stroke, heart failure and death. In endemic countries, this preventable disease is a stark measure of health system failure and inequality. Who does Rheumatic Heart Disease affect? RHD is the most common acquired heart disease in young people under the age of 25. It most often begins in childhood. If left untreated, RHD may progress to serious heart damage that kills or debilitates adolescents and young adults, and makes pregnancy hazardous. Although virtually eliminated in Europe and the Americas, the disease remains common in Africa, the Middle East, Central and South Asia, the South Pacific and in impoverished pockets of other regions. What causes Rheumatic Heart Disease? Like cervical or stomach cancer, RHD is a non-communicable disease that is caused by an infection. In those who are susceptible, a streptococcal sore throat develops into rheumatic fever (RF), which then damages heart valves, resulting in RHD. There is no cure for RHD, but symptoms can be managed with regular injections of antibiotics. Without this systematic control, RHD can result in stroke, heart failure and death. Two stories from the Pacific Pacemaca, a 7-year-old girl from Fiji, had been taken to the local hospital 15 times over the course of 18 months. Her complaints of swollen joints and shortness of breath were initially attributed to pneumonia. On her sixteenth visit to the local hospital, a nurse who had attended a RHD workshop run by the World Heart Federation recognized the symptoms of RHD. Pacemaca was immediately transferred to the main hospital, but it was too late to save her. She died three hours later. Had Pacemaca’s RHD been diagnosed earlier, she would have been able to control her disease with penicillin and would probably have survived. Malaki (not real name) was 8 years old when he was diagnosed with RHD in Samoa. His family received education from the dedicated RHD nurse and he is careful to take his monthly penicillin injections to avoid needing heart surgery. Today, he remains healthy and plays rugby for his school team. Samoa typically spends 15% of its entire health budget sending patients abroad for heart surgery – many cannot go due to lack of funds. Malaki makes sure to visit his doctor regularly to reduce his chance of requiring surgery (see photo). World Heart Federation 2751 WHF RHD Leaflet ART.indd 1 www.worldheart.org 12/05/2015 13:16 Action on Rheumatic Heart Disease Why are people still dying? Access to health care: • Healthcare provision is often weakest in the places most affected by RHD • Patients may be unable to cover expensive out-of-pocket costs in seeking medical help • When provided, RHD health services can drain resources from other health areas. Detection: What is the World Heart Federation doing? The WHF is working with governments, the World Health Organization, international bodies and the private sector to reduce deaths from RHD by 25% by 2025 for people under the age of 25. How: • Encouraging endemic countries to integrate RHD prevention and control into national health plans • Identifying ways to strengthen healthcare systems and equip • Communities can be poorly educated in the causes or symptoms of RF/RHD and may not seek medical attention for sore throats • Healthcare workers are often untrained in prevention or early detection of the disease • The most accurate detection of RHD relies on echocardiography, which is expensive, hard to transport, and requires training. healthcare providers to prevent and treat RHD • Funding projects in resource-poor areas to scale up efforts to tackle RHD • Convening experts to share best practice and strategies to combat RHD • Raising awareness of RHD and the need to treat sore throats • Promoting Universal Health Coverage to improve access to services and reduce impoverishment from RHD. Management: • RHD can be managed by monthly injections of antibiotics (Benzathine Penicillin G or BPG), but this requires systematic recordkeeping and follow-up • BPG quality and supply are unreliable, and the injections are painful • Late-stage RHD can require complex heart surgery, Get involved Whatever your background, you have the power to help us eliminate RHD in endemic regions across the world. The RHD community is at a pivotal stage and needs the following support: Health Ministers Take steps to integrate RHD into existing NCD and national health plans Advocates Raise awareness and showcase the need to integrate RHD into other development areas Health Professionals Support your organization’s efforts to prevent and control RHD Private Sector Share best practice on improving the supply of antibiotics, and support innovation in vaccine development and technology which is expensive and often has poor outcomes. Lack of political will to help: • The world has known how to prevent and control RHD for 50+ years, but has lacked political will to eliminate it • Primordial causes of RHD – poor sanitation, poor housing, overcrowding – have not been remedied • Until the RHD Action Alliance was established in 2015, there has been little global commitment to this issue. How to prevent and control Rheumatic Heart Disease Primordial prevention: Improvement of environmental and socio-economic conditions of populations at risk of RF and RHD. Primary prevention: Treatment of sore throat with antibiotics to reduce the incidence of RF. Secondary prevention: Use of antibiotics to reduce the recurrence of RF, which can lead to RHD. Tertiary prevention: Medical and surgical treatment of the complications of RF and RHD. World Heart Federation 2751 WHF RHD Leaflet ART.indd 2 About the World Heart Federation The World Heart Federation speaks and acts on behalf of its global membership to prevent and control cardiovascular disease (CVD). Using local insights from our Members, we combine leading science with life-changing policy to achieve a 25% reduction in CVD mortality by 2025. We envision a world free from the burden of preventable cardiovascular disease (CVD), in which all people from all backgrounds can access cardiovascular care that is effective, affordable and safe. For more information, contact [email protected] www.worldheart.org 12/05/2015 13:16
© Copyright 2024