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Related Concept Videos

Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Acute Pyelonephritis II: Diagnostic Studies and Management

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Related Experiment Videos

Implementing a national acute rheumatic fever case-finding program and registry in Nepal: protocol for a multi-site

Sheila Klassen1, Sandeepa Karki2, Alma Adler1,3

  • 1Center for Integration Science, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, United States.

Frontiers in Cardiovascular Medicine
|May 25, 2026
PubMed
Summary
This summary is machine-generated.

A new program in Nepal aims to improve early detection of acute rheumatic fever (ARF), the precursor to rheumatic heart disease (RHD), by integrating case-finding into routine healthcare. This initiative seeks to establish a standardized approach for better RHD management in low-resource settings.

Keywords:
Nepalacute rheumatic fevercase findingimplementation studyrheumatic heart disease

Related Experiment Videos

Area of Science:

  • Public Health
  • Cardiovascular Disease Epidemiology
  • Implementation Science

Background:

  • Rheumatic heart disease (RHD) is a major cause of preventable death in children and young adults in low-income countries.
  • Acute rheumatic fever (ARF), the precursor to RHD, is often undiagnosed, leading to delayed treatment and severe valvular disease.
  • Nepal faces a significant RHD burden but lacks a systematic approach for ARF identification and follow-up.

Purpose of the Study:

  • To describe the implementation of a standardized ARF case-finding program and integrated registry in Nepal.
  • To evaluate the program's acceptability, feasibility, and adoption within existing healthcare infrastructure.
  • To provide a model for strengthening ARF detection in other RHD-endemic regions.

Main Methods:

  • Implementing a standardized ARF case-finding program using modified Jones criteria and echocardiography across 11 hospitals.
  • Integrating the program into existing PEN-Plus chronic disease infrastructure.
  • Utilizing REDCap for centralized training and registry-based follow-up, evaluating implementation via Proctor's taxonomy and CFIR.

Main Results:

  • The study protocol outlines the implementation of a pragmatic ARF case-finding program.
  • Care-process indicators like diagnostic patterns and follow-up completion will be summarized over the first 12 months.
  • Implementation outcomes focus on acceptability, feasibility, and adoption, not clinical detection rates.

Conclusions:

  • This protocol details a pragmatic approach to embedding ARF case-finding into routine district-level care in Nepal.
  • Findings will guide future program evaluations, scale-up, and sustainability efforts.
  • The model may be replicable for improving ARF detection in similar low-resource settings globally.