Is population-based screening for rheumatic heart disease precluded by the Cairo accord? Echocardiography...and
Carlos E B Branco1, Roney O Sampaio1, Flavio Tarasoutchi1
1INCOR Department of Valvular Heart Disease, University of São Paulo School of Medicine, Hospital Israelita Albert Einstein, Sao Paolo, Brazil.
Insights
The Cairo Accord aimed to reduce rheumatic heart disease burden but overlooked echocardiographic screening. This approach misses a vital opportunity to detect and manage the disease effectively in populations.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Rheumatic heart disease (RHD) remains a significant global health burden, particularly in endemic regions.
- The 2017 Cairo Accord proposed strategies to mitigate RHD, emphasizing logistical and research-focused recommendations.
- Echocardiographic population screening was explicitly excluded from immediate implementation, designated solely for research purposes.
Purpose of the Study:
- To critically evaluate the Cairo Accord's recommendations regarding rheumatic heart disease management.
- To highlight the missed opportunity in excluding echocardiographic screening from population-level interventions.
- To advocate for the integration of echocardiographic screening into RHD control strategies based on existing evidence.
Main Methods:
- Review of the 2017 Cairo Accord on Rheumatic Heart Disease.
- Analysis of the rationale behind the Accord's 10 key recommendations.
- Assessment of the evidence supporting echocardiographic screening in RHD.
Main Results:
- The Cairo Accord outlined a comprehensive approach but relegated echocardiographic screening to research.
- A substantial body of evidence supports the utility of echocardiography in detecting RHD.
- Excluding screening programs represents a lost opportunity for early detection and intervention.
Conclusions:
- The current exclusion of echocardiographic population screening from the Cairo Accord's actionable recommendations is a significant oversight.
- Integrating echocardiographic screening could enhance early diagnosis and improve outcomes for rheumatic heart disease.
- Further research is needed to confirm the optimal implementation of screening, but existing data support its use now.
Abstract:
In the 2017, "Cairo Accord on Rheumatic Heart Disease-From Molecules to The Global Community" experts from endemic areas enumerated an approach to reduce the population burden of rheumatic heart disease. The 10 key recommendations include immediate logistical objectives as well as domains for further study. Echocardiographic population screening programs were relegated to research alone. Given the large body of supporting data, relegating echo screening to an investigational modality is an opportunity lost.
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