Death from rheumatic heart disease in rural Ethiopia

Clinical Outcomes in 3343 Children and Adults With Rheumatic Heart Disease From 14 Low- and Middle-Income Countries

“…7 By contrast, Gunther and colleagues reported a very high mortality rate of 125·3 per 1000 person-years in a small cohort of 47 patients in a community from Ethiopia, but there was an excessively high loss to follow-up rate of 44%. 16 Several of the factors which we found to be strongly associated with mortality and other major adverse outcomes are potentially amenable to intervention. The majority of our patients had moderate to severe disease and nearly a third were in NYHA class III/IV at enrolment, 9 and the severity of valve disease was the strongest predictor of mortality.…”

“…Though this proportion was lower than initially projected (20%), it reflects the challenging and resource constrained settings in which the study was conducted. 16,35 Moreover, significantly greater proportions of those lost to follow-up had severe disease, were in CHF or worse functional class at enrolment, or were less educated (Supplementary Table 2) and so our data may be an underestimate of the poor prognosis in this condition. Finally, this is a hospital-based registry of symptomatic patients and so our results cannot be extrapolated to unselected patients with the disease in the community.…”

“…2). The hazard for mortality remained higher for low-income (HR 1.95, 95% CI 1.51-2.50) and low-middle income countries (HR 1.51, 95% CI 16 1.17-1.92), when compared to upper middle income countries, after adjustment for patient age and sex. Adjustment for all other prognostic variables resulted in attenuation of risk for low income countries (HR 1.53, 95% CI 1.12-2.14), and low-middle income countries (HR 1.34, 95% CI 1.02-1.87).…”

Update on rheumatic heart disease

“…RHD still accounts for a majority of the cardiovascular mortality and morbidity among young people in developing countries. If left untreated, RHD can result in mean age of death less than 25 years in some endemic countries [6]. The disproportionately high prevalence in developing countries affecting the most vulnerable communities is related to overcrowding, inadequate hygiene, poor access to healthcare, and poor compliance with medications.…”

Single-walled carbon nanotubes based chemiresistive genosensor for label-free detection of human rheumatic heart disease

“…1-3 RHD is a worldwide problem and it is more common in Asian developing countries due to poor health facilities. [4][5][6] The usual detection methods of RHD infection are culture test, 7 biochemical test 7,8 impedimetric immunosensor, 9 multiplex PCR and genetic markers, [10][11][12] illumigene kit assay 13 and fluorescent in situ hybridization (FISH). 14 All the above methods are time taking, less sensitive and specific, costly and non-confirmatory based on a single test.…”