Rheumatic Heart Disease (RHD) is a preventable cardiovascular disease, caused by untreated strep throat and is of epidemic proportion in sub-Saharan Africa. Over 250,000 children and young adults die from RHD each year. This is a reality that we cannot and will not accept.
Heart Healers International, in partnership with Children’s National Health System, several other universities and hospitals on six continents, non-governmental organizations, and ministers of health are tackling the large burden of Rheumatic Heart Disease. Through our award-winning research, partnerships with medical practitioners and government officials, we are well-positioned to make a meaningful and lasting impact in Uganda in the fight against RHD. We aim to replicate the RHD care and prevention model we built in Uganda across sub-Saharan Africa and, ultimately, around the world to stem the tragic loss of life caused by this completely treatable disease.
For over a decade, we have partnered with the Uganda Heart Institute—the only Ugandan hospital that can build capacity for treating heart disease. Our two project locations –Kampala and Gulu–have committed and skilled teams of local doctors, nurses, government leaders, and community activists. We have key strategic relationships with the Ugandan Minister of Health and the Ugandan Ambassador to the United States and they support our vision to expand our efforts throughout Uganda with the goal of providing access to care for all Ugandan children with cardiac disease.
We know comprehensive RHD control programs can work. Developed nations with improved living conditions and treatment of strep throat have nearly eliminated RHD, while low-resource nations, such as Uganda, experience rampant RHD. Cuba and Costa Rica are rare exceptions to this paradigm, providing hope that screening, treatment, and prevention has the potential to lead to significant reduction of disease burden of RHD in our lifetime.
Most healthcare providers and patients in the developing world are unaware of the link between strep throat and RHD.
- We aim to develop generalizable and sustainable solutions.
- We are leveraging existing HIV infrastructure to develop regional centers of excellence for community education, training, and treatment.
- We aim to eliminate the knowledge gap with all healthcare workers in the country through increased awareness.
- We are meeting children where they are – in the primary schools – to educate and screen them for early disease.
- We are piloting a teacher education program through interactive educational modules that will dramatically increase public awareness about the early stages of the disease.
- We will study the effectiveness of the modules in the classroom through testing of knowledge transfer and in the field by tracking increased number of children referred and treated for strep throat.
Using our work in Uganda, we aim to develop and validate a plan for sore throat management that can be adopted into the national integrated management of childhood illness strategies. We will track rates of sore throat presentation to primary health centers and barriers to appropriate delivery of primary penicillin injections.
Our work shows that echocardiographic screening provides the best chance of early RHD detection. Dr. Andrea Beaton’s 2012 publication in “Circulation”, the leading journal for heart disease in the world, was named one of the top ten research advances by the American Heart Association in 2012. This work has gained global recognition and we have received several grants including the National Institutes of Health, World Heart Federation, Verizon Foundation and Edwards Foundation. Current initiatives, using non-physicians and handheld ultrasound devices are working towards making school-based screening a sustainable public health model for RHD control. We have already screened over 10,000 Ugandan children, with 1.5% now on secondary prophylaxis to prevent disease progression. Research is underway to refine screening protocols, expand the reach of screening, continue the validation of handheld devices, and examine cost-effectiveness. We are also collaborating on a national RHD registry, working to establish regional penicillin clinics, and studying ways to improve adherence to monthly penicillin injections.
Despite the large burden of rheumatic heart disease, there is reason for hope. Our collaboration with groups of experts in all corners of the globe will help educate and empower communities to improve primary and secondary prevention of RHD.