Tertiary prevention and treatment of rheumatic heart disease: a National Heart, Lung, and Blood Institute working group summary.

Autor:	Vervoort D; Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada., Yilgwan CS; Departments of Paediatrics, Jos University Teaching Hospital, Jos, Plateau, Nigeria., Ansong A; Outpatient Cardiology, Children's National Hospital, Washington, District of Columbia, USA., Baumgartner JN; National Institutes of Health Office of Disease Prevention, Bethesda, Maryland, USA., Bansal G; Division of International Training and Research, John E Fogarty International Center, Bethesda, Maryland, USA., Bukhman G; Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Program in Global Noncommunicable Disease and Social Change, Harvard Medical School, Boston, Massachusetts, USA., Cannon JW; Department of Global Health and Population, Telethon Kids Institute, Nedlands, Western Australia, Australia., Cardarelli M; Pediatric Heart Surgery, Inova Children Hospital, Falls Church, Virginia, USA., Cunningham MW; The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., Fenton K; National Heart Lung and Blood Institute, Bethesda, Maryland, USA., Green-Parker M; National Institutes of Health Office of Disease Prevention, Bethesda, Maryland, USA., Karthikeyan G; All India Institute of Medical Sciences, New Delhi, Delhi, India., Masterson M; National Heart Lung and Blood Institute, Bethesda, Maryland, USA., Maswime S; Global Surgery, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa., Mensah GA; National Heart Lung and Blood Institute, Bethesda, Maryland, USA., Mocumbi A; Non Communicable Diseases, Instituto Nacional de Saúde, Maputo, Mozambique.; Universidade Eduardo Mondlane, Maputo, Mozambique., Kpodonu J; Division of Cardiac Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA., Okello E; Cardiology, Uganda Heart Institute Ltd, Kampala, Uganda., Remenyi B; Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory of Australia, Australia., Williams M; National Heart Lung and Blood Institute, Bethesda, Maryland, USA., Zühlke LJ; South African Medical Research Council, Tygerberg, South Africa.; Department of Medicine, Red Cross War Memorial Children's Hospital, Rondebosch, Western Cape, South Africa., Sable C; Division of Cardiology, Children's National Hospital, Washington, District of Columbia, USA csable@childrensnational.org.
Jazyk:	angličtina
Zdroj:	BMJ global health [BMJ Glob Health] 2023 Oct; Vol. 8 (Suppl 9).
DOI:	10.1136/bmjgh-2023-012355
Abstrakt:	Although entirely preventable, rheumatic heart disease (RHD), a disease of poverty and social disadvantage resulting in high morbidity and mortality, remains an ever-present burden in low-income and middle-income countries (LMICs) and rural, remote, marginalised and disenfranchised populations within high-income countries. In late 2021, the National Heart, Lung, and Blood Institute convened a workshop to explore the current state of science, to identify basic science and clinical research priorities to support RHD eradication efforts worldwide. This was done through the inclusion of multidisciplinary global experts, including cardiovascular and non-cardiovascular specialists as well as health policy and health economics experts, many of whom also represented or closely worked with patient-family organisations and local governments. This report summarises findings from one of the four working groups, the Tertiary Prevention Working Group, that was charged with assessing the management of late complications of RHD, including surgical interventions for patients with RHD. Due to the high prevalence of RHD in LMICs, particular emphasis was made on gaining a better understanding of needs in the field from the perspectives of the patient, community, provider, health system and policy-maker. We outline priorities to support the development, and implementation of accessible, affordable and sustainable interventions in low-resource settings to manage RHD and related complications. These priorities and other interventions need to be adapted to and driven by local contexts and integrated into health systems to best meet the needs of local communities. Competing Interests: Competing interests: JK, SM, MWC and CSY have received funding support from the National Institutes of Health. SM and LJZ received funding support from the South African Medical Research Council. SM received funding support from UNICEF, NIHR and Operation Smile. LJZ also receives support from the National Research Foundation of South Africa (NRFSA), as well as the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement, via the African Research Leader Award (MR/S005242/1). CSY received consulting fees from the WHO. MWC received fees as a consultant for Vaxform Incorporated, Serum India Institute and Pfizer Incorporated. MWC is the Chief Scientific Officer and co-founder, with financial interest, in Moleculera Labs, a commercial laboratory for diagnostic testing of autoantibodies against the heart and brain. DV is supported by the Canadian Institutes of Health Research (CIHR) Vanier Canada Graduate Scholarship. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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