Overview

PASCAR TASK FORCE: RHEUMATIC HEART DISEASE

Task Force Chair Leaders: 

Chair: Dr Emmy Okello (Uganda): emmyoks@gmail.com

Past Chair:Professor Liesl Zuhlke (South Africa)

Click here to view: PASCAR RHD Task Force Committee Structure 2018

Click here to view: PASCAR Task Force Rheumatic Heart Disease: Report and Plans for 2018 - 2021 

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major causes of heart failure, stroke and death among African women and children, despite being preventable and imminently treatable. From 21 to 22 February 2015, the Social Cluster of the Africa Union Commission (AUC) hosted a consultation with RHD experts convened by the Pan-African Society of Cardiology (PASCAR) in Addis Ababa, Ethiopia, to develop a ‘roadmap’ of key actions that need to be taken by governments to eliminate ARF and eradicate RHD in Africa. Seven priority areas for action were adopted: (1) create prospective disease registers at sentinel sites in affected countries to measure disease burden and track progress towards the reduction of mortality by 25% by the year 2025, (2) ensure an adequate supply of high-quality benzathine penicillin for the primary and secondary prevention of ARF/ RHD, (3) improve access to reproductive health services for women with RHD and other non-communicable diseases (NCD), (4) decentralise technical expertise and technology for diagnosing and managing ARF and RHD (including ultrasound of the heart), (5) establish national and regional centres of excellence for essential cardiac surgery for the treatment of affected patients and training of cardiovascular practitioners of the future, (6) initiate national multi-sectoral RHD programmes within NCD control programmes of affected countries, and (7) foster international partnerships with multinational organsations for resource mobilisation, monitoring and evaluation of the programme to end RHD in Africa. This Addis Ababa communiqué has since been endorsed by African Union heads of state, and plans are underway to implement the roadmap in order to end ARF and RHD in Africa in our lifetime. (click here to download pdf)

Publications

Joselyn Rwebembera, James Marangou, Emmy Okello, et al. 2023 World Heart Federation guidelines for the echocardiographic diagnosis of rheumatic heart disease. Nature Reviews Cardiology. https://doi.org/10.1038/s41569-023-00940-9 (click here to read and download)

Dougherty, S. Okello, E & Mwangi, J. et al. 2023. Rheumatic Heart Disease. JACC Focus Seminar: Tropical Medicine. 81: 1. (click here to read and download)

Ali, SKM. 2023. Rheumatic heart disease control: the time for a paradigm shift. Sudanese Journal of Paediatrics. 22:2 (click here to read and download)

Andrea Beaton, M.D., Emmy Okello, Ph.D., Joselyn Rwebembera, M.Med., et al.  Secondary Antibiotic Prophylaxis for Latent Rheumatic Heart Disease January 20, 2022  N Engl J Med 2022; 386:230-240  DOI: 10.1056/NEJMoa2102074 (click here to read and download)

Emmy Okello, Andrea Beaton, et al.(10 May 2021) Targeted investment needed to end rheumatic heart disease in Africa.  1-s2.0-S2214109X21002151-main  (Click Here to download pdf) 

Pearce S, Bowen AC, Engel ME, de la Lande M, Barth DD (2020). The incidence of sore throat and group A streptococcal pharyngitis in children at high risk of developing acute rheumatic fever: A systematic review and meta-analysis. PLoS ONE 15(11): e0242107 (Click Here to download pdf) 

Availability and administration of benzathine penicillin G for the prevention of rheumatic fever in Africa: report of the Working Group on Penicillin, Pan-African Society of Cardiology Task Force on Rheumatic Heart Disease 2020  (Click Here to download pdf) Sulafa Ali, Aidan Long, Jean B Nikiema, Geoffrey Madeira, Rosemary Wyber

Community Awareness of Sore Throat And Rhuematic Heart Disease in Northern Ethiopia (click here to download pdf)   Author(s): Abraha Hailu, MD, Temesgen Tsega, MD, Tesfay Gebregziabher, PhD, Haftom Temesgen Abebe, PhD, Hagazi Tesfay, MD, Hagos Kahsay, MD, Mulugeta Naizgi, MD, Samuel Berhane, MD, Marta Yemane, MD, Yonas Berhane, MD, Christian Leuner, MD, Gabriele Wehr MD

The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high-income setting: a prospective cohort study. PubMed - NCBI (Click here for more information)

Reach: To Stop Rheumatic Heart Disease - Strategic Plan 2019 - 2020 (click here to download pdf)

Sulafa Ali, Noha Karadawi, et al. Patterns, outcomes and trends in hospital visits of un-operated and operated children with rheumatic heart disease in Sudan. Cardiovascular Diagnosis and Therapy, 2019 (click here to download pdf)

Karen Sliwa, Alastair White, Pillar Milan, et al. Momentum builds for a global response to rheumatic heart disease. European Heart Journal, Volume 39, Issue 48, 21 December 2018 (click here to download pdf)

Ana O Mocumbi, Keila KF Jamal, et al. The Pan-African Society of Cardiology position paper on reproductive healthcare for women with rheumatic heart disease. CVJA, August 2018 (click here to download pdf)

Azza M. A. M. Abul-Fadl, Maha M. Mourad, et al. Trends in Deaths from Rheumatic Heart Disease in the Eastern Mediterranean Region: Burden and Challenges. J. Cardiovasc. Dev. Dis. 2018 (click here to download pdf)

Ashley K. Keates, Ana O. Mocumbi, Mpiko Ntsekhe, et al. Cardiovascular disease in Africa: Epidemiological profile and challenges. Nature Reviews Cardiology, May 2017 (click here to download pdf)

Aidan Long, Joyce Chipili Lungu, et al. A programme to increase appropriate usage of benzathine penicillin for management of streptococcal pharyngitis and rheumatic heart disease in Zambia. CVJA Aug 2017 (click here to download pdf)

Gabriella Watson, Bintou Jallow, et al. Acute rheumatic fever and rheumatic heart disease in resource-limited settings. BMJ April 2017 (click here to download pdf)

Emmy Okello, Chris T. Longenecker. Rheumatic heart disease in Uganda: predictors of morbidity and mortality one year after presentation. BMC Cardiovasc Disord, January 2017 (click here to download pdf)

Faten Trikia, Jihen Jdidib, et al. Characteristics, aetiological spectrum andmanagement of valvular heart disease in aTunisian cardiovascular centre. Elsevier, Archives of Cardiovascular Disease 2017 (click here to download pdf)

Tadesse Gemechu, Hani Mahmoud, et al. Community-based prevalence study of rheumatic heart disease in rural Ethiopia. European Journal of Preventive Cardiology 2017 (click here to download pfd)

David Watkins, Liesl Zühlke, Mark Engel, et al. Seven key actions to eradicate rheumatic heart disease in Africa: the Addis Ababa Communiqué. CVJA, January 2016 (click here to download pdf)

Samue Kinguéa, Serigne Abdou Ba, et al. The VALVAFRIC study: A registry of rheumatic heart disease in Western and Central Africa. Elsevier, May 2016 (click here to download pdf)

Bongani Mayosi. 2016 National Rheumatic Fever week: Status of Rheumatic Heart Disease in South Africa. SAMJ, 2016 August. (click here to download pdf)

M Shung-King, L Zühlke, M E Engel, et al. Asymptomatic rheumatic heart disease in South African schoolchildren: Implications for addressing chronic health conditions through a school health service. SAMJ, August 2016. (click here to download pdf)

David Watkins, Solomon J. Lubinga, et al. A Cost-Effectiveness Tool to Guide the Prioritization of Interventions for Rheumatic Fever and Rheumatic Heart Disease Control in African Nations. Plos, August 2016 (click here to download pdf)

Mvondo CM, Pugliese M, et al. Surgery for rheumatic mitral valve disease in sub-saharan African countries: why valve repair is still the best surgical option. Pan Afr Med J. August 2016. (click here to download pdf)

Article on RHD in Life Healthcare magazine's Jun 2016 issue (click here to download pdf)

Zühlke L, Karthikeyan G, Engel ME, et al. Clinical Outcomes in 3343 Children and Adults with Rheumatic Heart Disease from 14 Low and Middle Income Countries: 2-Year Follow-up of the Global Rheumatic Heart Disease Registry (the REMEDY study) (click here to download pdf)

Shanti Nulu, Robert C. Neely, Zeina Tawakol, et al. Global Cardiology Science & Practice - RHD African Leaders take Action Addis Ababa - Conference Report .GCSP 2016 (click here to download pdf)

Rebecca H. Lumsden, Constantine Akwanalo, et al. Clinical and geographic patterns of rheumatic heart disease in outpatients attending cardiology clinic in western Kenya. Elsevier, International Journal of Cardiology 2016 (click here to download pdf)

Gleason B, Mirembe G, et al. Brief Report: Prevalence of Latent Rheumatic Heart Disease Among HIV-Infected Children in Kampala, Uganda. J Acquir Immune Defic Syndr. February 2016. (click here to download pdf)

Mohamed Rezk, Awni Gamal. Maternal and fetal outcome in women with rheumatic heart disease: a 3-year observational study. Arch Gynecol Obstet 2016 (click here to download pdf)

Dejuma Yadeta, Abrha Hailu, et al. Prevalence of rheumatic heart disease among school children in Ethiopia: A multisite echocardiography-based screening. Elsevier, International Journal of Cardiology 2016 (click here to download pdf)

Amy Sims Sanyahumbi, Craig A. Sable, et al. Task shifting to clinical officer-led echocardiography screening for detecting rheumatic heart disease in Malawi, Africa. Cardiology in the Young 2016 (click here to download pdf)

Addis Ababa, Ethiopia. Meeting Report. Development of a Roadmap for the Eradiation of Rheumatic Heart Disease in Africa: 21-22 February 2015 English (click here to download pdf)

Addis Ababa, Ethiopia. Meeting Report. Development of a Roadmap for the Eradiation of Rheumatic Heart Disease in Africa: 21-22 February 2015 French (click here to download pdf)

Addis Ababa, Ethiopia. Meeting Report. Development of a Roadmap for the Eradiation of Rheumatic Heart Disease in Africa: 21-22 February 2015 Arabic (click here to download pdf)

Addis Ababa, Ethiopia. Meeting Report. Development of a Roadmap for the Eradiation of Rheumatic Heart Disease in Africa: 21-22 February 2015 Portuguese (click here to download pdf)

WanZhu Zhang, Emmy Okello, et al. Proportion of patients in the Uganda rheumatic heart disease registry with advanced disease requiring urgent surgical interventions. African Health Sciences. December 2015 (click here to download pdf)

Joris van Dam, John Musuku, et al. An open-access, mobile compatible, electronic patient register for rheumatic heart disease (‘eRegister’) based on the World Heart Federation’s framework for patient registers. CVJA, October 2015 (click here to download pdf)

Mark E Engel, Abraham Haileamlak, Liesl Zühlke. Prevalence of rheumatic heart disease in 4720 asymptomatic scholars from South Africa and Ethiopia. Valvular Heart Disease BMJ. Heart 2015 August (click here to download pdf)

Georges Antoine Bazolo Ba Ngouala, Désiré Alain Affangla, et al. The prevalence of symptomatic infantile heart disease at Louga Regional Hospital, Senegal. CVJAfrica. Aug 2015 (click here to download pfd)

A Balbaa1, A ElGuindy, et al. An evaluation of secondary prophylaxis for rheumatic heart disease in rural Egypt. Global Cardiology Science and Practice 2015 (click here to download pfd)

P Gapu, M Bwakura-Dangarembizi,et al. Rheumatic fever and rheumatic heart disease among children presenting to two referral hospitals in Harare, Zimbabwe. SAMJ May 2015 (click here to download pdf)

Sirageldin M Kheir, Sulafa Khalid M Ali. The control of rheumatic fever and rheumatic heart disease: a call to raise the awareness. Sudanese Journal of Pediatrics, 2014 (click here to download pdf)

Belete Habte, Fessahaye Alemseged, et al. The pattern of cardiac diseases at the cardiac clinic of jimma university specialised hospital, South west Ethiopia. Journal List, Ethiop J Health Sci, July 2010 (click here to download pdf)

Corporate Support and Partners

News and Events

PASCAR RHD Webinar for Journalists, 9 October 2023

                 Click to Register                                                                            Click to Learn More

PASCAR: RHD Pulse Quarterly Newsletter

CLICK HERE to view the PASCAR RHD Pulse Quarterly Newsletter

Paving the way to ending Rheumatic Heart Disease: From Policy to People

Rheumatic heart disease (RHD) affects 39 million people worldwide and is the most commonly acquired #heartdisease in people under the age of 25.
It mostly affects children and adolescents in low-resource settings where poverty is widespread and access to health services is limited.

• CLICK HERE to view the The Beat of Change: Rheumatic Heart Disease in Mozambique Movie
• CLICK HERE to read the Prevention and Management of RHD in the African Union: Interview with Prof Karen Sliwa

RHD and RF WHO RESOLUTION - Hon Minister of Health and Social Services Dr Bernard Haufiku - Interview with Dr Christopher Hugo-Hamman, Wednesday 10 October 2018 (click here to download pdf)

PASCAR RHD WHF Small Grant Winners 2017 - Report Summary (click here to download pdf)

RHD Action Press Release: Uganda RHD Stakeholders’ Meeting; 2-3 November 2017 (click here to download)

RHD Action: Uganda RHD Stakeholders' Meeting Article: 2-3 November 2017 (click here to download pdf)

Listen to my Heart – Patient Awareness Event in Kampala, Uganda, 1 November 2017 (click here to download pdf)

PASCAR Small Grant Award PROGRESS REPORT - Namibia - Dr Tangeni Auala (September 2017) (click here to download pdf)

PASCAR Small Grant Award PROGRESS REPORT - Nigeria - Dr Fidelia Bode-Thomas (September 2017) (click here to download pdf)

PASCAR Small Grant Award PROGRESS REPORT - Zimbabwe - Prof Jonathan Matenga (August & September 2017) (click here to download pdf)

Alastair White (WHF) Rheumatic Heart Disease Congress in Cairo, Egypt, January 2017 (click here to download pdf)

Sherri Schwaninger, World Heart Day - BeatRHD Zambia, September 2016 (click here to download pdf)

Action 1: Registries

Joris van Dam, John Musuku, Liesl J Zühlke, et al. An open-access, mobile compatible, electronic patient register for rheumatic heart disease (‘eRegister’) based on the World Heart Federation’s framework for patient registers. Cardiovascular Journal of Africa - Advance Online Publication, October 2015 (click here to download)

Action Group 1 - October 2016 Meeting Minutes (click here to download)

Action Group 1 - November 2016 Meeting Minutes (click here to download)

Action Group 1 - December 2016 Meeting Minutes (click here to download)

Action Group 1 - February 2017 Meeting Minutes (click here to download)

Action Group 1 - March 2017 Meeting Minutes (click here to download)

Action 2: Benzathine penicillin

Rosemary Wyber, Timothy Johnson, Jonathan Carapetis, et al. RHD Action Global Status of BPG Report. 2016 (click here to download PDF)

Geoffrey Madeira, Ana Olga Mocumbi, Bongani Mayosi. Advice to Health professionals: Use of lignocaine as a diluent to reduce the pain associated with the administration of BPG. SAMJ 2016 (click here to download PDF). 

Action Group 2 - October 2016 Meeting Minutes (click here to download)

Action Group 2 - November 2016 Meeting Minutes (click here to download)

Action Group 2 - January 2017 Meeting Minnutes (click here to download)

Action Group 2 - February 2017 Meeting Minutes (click here to download)

Action 3: Reproductive Health Services

Ana O Mocumbi, Keila KF Jamal, et al. The Pan-African Society of Cardiology position paper on reproductive healthcare for women with rheumatic heart disease. CVJA, August 2018 (click here to download pdf)

Jolien W. Roos-Hesselink, Jerome Cornette, Karen Sliwa, et al. Prevention: Contraception and Cardiovascular Disease, European Heart Journal, 2015 (click here to download pdf)

Action Group 3 - August 2016 Meeting Minutes (click here to download)

Action Group 3 - September 2016Meeting Minutes (click here to download)

Action Group 3 - October 2016 Meeting Minutes (click here to download)

Action Group 3 - February 2017 Meeting Minutes (click here to download)

Action Group 3 - May 2017 Meeting Minutes (click here to download)

Action 4: Technical Expertise

Alice Kidder, Gene Kwan, Corrado Cancedda, et al. The PIH Guide to Chronic Care Integration for Endemic Non-Communicable Diseases, Rwanda Edition, 2011 (click here to download pdf)

Gene F. Kwan, Alice K. Bukhman, Ann C. Miller, et al. A Simplified Echocardiographic Strategy for Heart Failure Diagnosis and Management Within an Integrated Noncommunicable Disease Clinic at District Hospital Level for Sub-Saharan Africa, (Kwan-A Simplified Echocardiographic Strategy), JACC: Heart Failure, 2013 (click here to download pdf)

Action Group 4 - August 2016 Meeting Minutes (click here to download)

Action Group 4 - September 2016 Meeting Minutes (click here to download)

Action Group 4 - November 2016 Meeting Minutes (click here to download)

Action 5: Cardiac Surgery

Action Group 5 - August 2016 Meeting Minutes (click here to download)

Action Group 5 - September 2016 Meeting Minutes (click here to download)

Action 6: National RHD control programmes

RHD and RF WHO RESOLUTION - Hon Minister of Health and Social Services Dr Bernard Haufiku - Interview with Dr Christopher Hugo-Hamman, Wednesday 10 October 2018 (click here to download pdf)

Christopher Hugo-Hamman, Norbert Forster. National Advisory Committee for the Prevention and Control of Rheumatic Fever and Rheumatic Heart Disease in Namibia, CVJAfrica December 2015 (click here to download pdf)

Action Group 6 - September 2016 Meeting Minutes (click here to download)

Action Group 6 - November 2016 Meeting Minutes (click here to download)

Action Group 6 - December 2016 Meeting Minutes (click here to download)

Action Group 6 - April 2017 Meeting Minutes (click here to download)

Action Group 6 - May 2017 Meeting Minutes (click here to download)

Action 7: Partnerships

Action Group 7 - Augustus 2016 Meeting Minutes (click here to download)

Action Group 7 - September 2016 Meeting Minutes (click here to download)

Action Group 7 - November 2016 Meeting Minutes (click here to download)

Action Group 7 - February 2017 Meeting Minutes (click here to download)

Communication Toolkit and Resources

Rheumatic Heart Disease Webinar for Journalists Resources: Click to Access

WHF Tips Handbook (RhEACH) - Tools for implementing rheumatic heart disease control programmes

Video - (Take Heart – road to Addis) - A short film with Prof Bongani Mayosi that contains the Road to Addis: The political mandate from the heads of state of African Countries to stop RHD

Video - Interview with Namibian MoH - Namibian Broadcasting Corporate Interview with DR Chris Hugo-Hamman and Minister of Health on RHD (19 March 2016) 

Video - RHD Conference Gala video (Egypt) - Prof Magdi Yacoub from Chain of Hope presents Haile’s story, a 12 year old orphan with RHD

Sudan RHD Poster: English /  Arabic

Sudan Training Module: 

- Physician Module: Click here to load PDF

- Medical Assisstant and Nurse Module: Click here to load PDF

RHD Education for healthcare workers: Download Powerpoint

Global Resolution / RHD Action: Click here to view 

Coming soon:

Powerpoint presentation on Report of RHD Action Groups