Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up.
Background As little is known about the prevalence and clinical progression of subclinical (latent) rheumatic heart disease (RHD) in sub-Saharan Africa, we report the results of a 5 year follow-up of a community based, echocardiographic study of the disease, originally carried out in a rural area ar...
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ftdoajarticles:oai:doaj.org/article:1622997563904090b81f3aa37561152d 2023-05-15T15:16:44+02:00 Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up. Tadesse Gemechu Eldryd H O Parry Magdi H Yacoub David I W Phillips Susy Kotit 2021-10-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0009830 https://doaj.org/article/1622997563904090b81f3aa37561152d EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0009830 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009830 https://doaj.org/article/1622997563904090b81f3aa37561152d PLoS Neglected Tropical Diseases, Vol 15, Iss 10, p e0009830 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1371/journal.pntd.0009830 2022-12-31T16:22:38Z Background As little is known about the prevalence and clinical progression of subclinical (latent) rheumatic heart disease (RHD) in sub-Saharan Africa, we report the results of a 5 year follow-up of a community based, echocardiographic study of the disease, originally carried out in a rural area around Jimma, Ethiopia. Methods Individuals with evidence of RHD detected during the baseline study as well as controls and their family members were screened with a short questionnaire together with transthoracic echocardiography. Results Of 56 individuals with RHD (37 definite and 19 borderline) in the original study, 36 (26 definite and 10 borderline) were successfully located 57.3 (range 44.9-70.7) months later. At follow-up two thirds of the definite cases still had definite disease; while a third had regressed. Approximately equal numbers of the borderline cases had progressed and regressed. Features of RHD had appeared in 5 of the 60 controls. There was an increased risk of RHD in the family relatives of borderline and definite cases (3.8 and 4.0 times respectively), notably among siblings. Compliance with penicillin prophylaxis was very poor. Conclusions We show the persistence of echocardiographically demonstrable RHD in a rural sub-Saharan population. Both progression and regression of the disease were found; however, the majority of the individuals who had definite features of RHD had evidence of continuing RHD lesions five years later. There was an increased risk of RHD in the family relatives of borderline and definite cases, notably among siblings. The findings highlight the problems faced in addressing the problem of RHD in the rural areas of sub-Saharan Africa. They add to the evidence that community-based interventions for RHD will be required, together with appropriate ways of identifying active disease, achieving adequate penicillin prophylaxis and developing vaccines for primary prevention. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 15 10 e0009830 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Tadesse Gemechu Eldryd H O Parry Magdi H Yacoub David I W Phillips Susy Kotit Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background As little is known about the prevalence and clinical progression of subclinical (latent) rheumatic heart disease (RHD) in sub-Saharan Africa, we report the results of a 5 year follow-up of a community based, echocardiographic study of the disease, originally carried out in a rural area around Jimma, Ethiopia. Methods Individuals with evidence of RHD detected during the baseline study as well as controls and their family members were screened with a short questionnaire together with transthoracic echocardiography. Results Of 56 individuals with RHD (37 definite and 19 borderline) in the original study, 36 (26 definite and 10 borderline) were successfully located 57.3 (range 44.9-70.7) months later. At follow-up two thirds of the definite cases still had definite disease; while a third had regressed. Approximately equal numbers of the borderline cases had progressed and regressed. Features of RHD had appeared in 5 of the 60 controls. There was an increased risk of RHD in the family relatives of borderline and definite cases (3.8 and 4.0 times respectively), notably among siblings. Compliance with penicillin prophylaxis was very poor. Conclusions We show the persistence of echocardiographically demonstrable RHD in a rural sub-Saharan population. Both progression and regression of the disease were found; however, the majority of the individuals who had definite features of RHD had evidence of continuing RHD lesions five years later. There was an increased risk of RHD in the family relatives of borderline and definite cases, notably among siblings. The findings highlight the problems faced in addressing the problem of RHD in the rural areas of sub-Saharan Africa. They add to the evidence that community-based interventions for RHD will be required, together with appropriate ways of identifying active disease, achieving adequate penicillin prophylaxis and developing vaccines for primary prevention. |
format |
Article in Journal/Newspaper |
author |
Tadesse Gemechu Eldryd H O Parry Magdi H Yacoub David I W Phillips Susy Kotit |
author_facet |
Tadesse Gemechu Eldryd H O Parry Magdi H Yacoub David I W Phillips Susy Kotit |
author_sort |
Tadesse Gemechu |
title |
Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up. |
title_short |
Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up. |
title_full |
Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up. |
title_fullStr |
Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up. |
title_full_unstemmed |
Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up. |
title_sort |
community-based prevalence of rheumatic heart disease in rural ethiopia: five-year follow-up. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doi.org/10.1371/journal.pntd.0009830 https://doaj.org/article/1622997563904090b81f3aa37561152d |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 10, p e0009830 (2021) |
op_relation |
https://doi.org/10.1371/journal.pntd.0009830 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009830 https://doaj.org/article/1622997563904090b81f3aa37561152d |
op_doi |
https://doi.org/10.1371/journal.pntd.0009830 |
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PLOS Neglected Tropical Diseases |
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15 |
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10 |
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e0009830 |
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