Preventive Interventions to Reduce the Burden of Rheumatic Heart Disease in Populations at Risk: A Systematic Review.

Area of Science:

• Public Health
• Infectious Diseases
• Cardiology

Background:

• Rheumatic heart disease (RHD) is a preventable yet significant global health issue, particularly in low-middle-income countries.
• Existing evidence on the effectiveness of RHD preventive interventions is fragmented.
• This systematic review evaluates the efficacy of various strategies aimed at reducing RHD's impact.

Approach:

• A comprehensive literature search identified studies on primordial, primary, and secondary RHD prevention.
• Effectiveness data for interventions were systematically collected and analyzed.
• Methodological quality was assessed using Joanna Briggs Institute tools, with narrative synthesis employed.

Key Points:

• School-based primary prevention, focusing on early detection and penicillin treatment of Group A Streptococcus pharyngitis, shows potential in reducing infections and acute rheumatic fever.
• Community-based programs utilizing diverse strategies have also demonstrated success in mitigating RHD burden.
• Evidence from low-middle-income countries is limited, and rigorous impact evaluations are scarce.

Conclusions:

• Preventive interventions are crucial for decreasing the incidence and burden of Group A Streptococcus pharyngitis, acute rheumatic fever, and RHD.
• There is a critical need for rigorous evaluations and comprehensive analyses to inform public health policies.
• Effective strategies are essential for preventing and reducing RHD in diverse global populations.