Rheumatic Fever Week: The Role of Scientific Research in Preventing Harm
The National Department of Health (NDOH) South Africa declared the first week of August Rheumatic Fever Week more than 25 years ago, bringing long overdue recognition to this preventable condition which disproportionately affects women and children in lower and middle-income countries throughout Africa, Asia, the Middle East and Pacific, including South Africa. This year, Rheumatic Fever Week is being observed from 1st through 7th August with the intention of raising awareness of the harm that rheumatic fever (RF) can cause. Moreover, the Heart and Stroke Foundation South Africa (HSFSA) and the Children’s Heart Disease Research Unit (CHDRU) would like to play a role in disseminating more information and knowledge regarding the relationship between RF and rheumatic heart disease (RHD).
What is Rheumatic Fever?
Rheumatic fever is an abnormal immune reaction to a common bacterium called Group A Streptococcus. Patients typically experience a range of symptoms that can include joint pain, fever above 38°C, generally feeling unwell, shortness of breath, a skin rash and, on rarer occasions, uncontrolled body movements. Rheumatic fever is preceded two or three weeks earlier by a bacterial throat infection, commonly called strep throat.
A single episode or repeated episodes of rheumatic fever can cause damage to the heart valves, resulting in rheumatic heart disease. Left untreated, rheumatic heart disease will eventually lead to further heart valve damage, stroke, heart failure, and even premature death. The disease requires life-long medication, medical surveillance and often heart valve replacement surgery. Significantly however, rheumatic fever can be completely prevented by the oldest antibiotic available, namely, penicillin. Key to this preventive step is an early diagnosis.
Recent Scientific Advances and Current Research on RHD
The pathophysiologic characteristics and genetics of rheumatic heart disease are not fully understood. Funding for more research is needed to fill this gap as well as to investigate what the best practice treatment strategies are until such time as effective vaccines against strep throat are developed. Professor Liesl Zühlke, paediatric cardiologist and director of the CHDRU reminds us that “a sore throat can damage your heart”.
Africa is at the forefront of much scientific research and current advances in the RF/RHD landscape. These studies were conducted in Africa and/or by African researchers adding to the growing body of literature and working towards the elimination of RF/RHD:
What Do These Findings Mean for RHD Prevention Advocates and the Public?
While these scientific advances and ongoing research are steps in the right direction, it takes time for findings to be put into practice. Continued prevention efforts at the community level are therefore very much recommended. These could be focussed on raising community awareness of Group A streptococcal throat infection and the link with rheumatic fever and rheumatic heart disease. Likewise, improving living conditions, hygiene and access to primary health care should continue to be prioritised.
Moreover, both advocates and those affected by RF/RHD need to mobilize and constructively work together to ensure the correct access to essential care for RF and RHD, particularly in the public sector. Prof Pamela Naidoo, CEO of the HSFSA states that the organization plays an important role in education and knowledge dissemination for RF, RHD, as well heart disease in general. Please contact the HSFSA for more information. In addition, If you’d like to raise awareness, consider sharing these useful infographics with schoolteachers and care givers in your community! If you are interested in keeping up to date with RF/RHD research and activities from around the world, feel free to subscribe to the quarterly RHD Pulse newsletter. You can find previous editions released this year here.
To find out even more, take a listen to this conversation between Prof Zühlke and Lebogang Mabange at Africa Rise and Shine.
This news piece was adapted from a press release published by the Heart and Stroke Foundation South Africa (HSFSA).