Abstract:
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.
