scholarly journals Echocardiography Screening for Diagnosis of Latent RHD Using Nurses: Is the Project Feasible for Nepal?

2021 ◽  
Vol 18 (2) ◽  
pp. 1-5
Author(s):  
Prakash Raj Regmi ◽  
Riju Kafle
Keyword(s):  
Heart Disease ◽  
Early Detection ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Endemic Country ◽  
Resource Limited ◽  
Significant Burden ◽  
Remote Setting ◽  
Limited Setting ◽  
Rheumatic Heart

Rheumatic Heart Disease (RHD) is a preventable disease which occurs years or decades after the onset of Acute Rheumatic Fever (ARF) in childhood. The prevalence of RHD is still high in Nepal, with most cases of latent RHD concentrated in the rural, resource-limited setting. The sequelae of latent RHD cases often manifest decades later, causing a significant burden on the health system. Training of non-experts with simple protocols in such remote setting for screening of latent RHD is showing promising results worldwide. Screening of latent RHD is advocated in RHD endemic areas where early detection by echo screening can alleviate a massive burden on morbidity and mortality in the future. More research is needed to explore this possibility in the context of an endemic country like Nepal to tackle the burden of RHD.

Acute rheumatic fever and rheumatic heart disease in resource-limited settings

2015 ◽  
Vol 100 (4) ◽  
pp. 370-375 ◽  
Author(s):  
Gabriella Watson ◽  
Bintou Jallow ◽  
Kirsty Le Doare ◽  
Kuberan Pushparajah ◽  
Suzanne T Anderson
Keyword(s):  
Heart Disease ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Acute Rheumatic Fever ◽  
Treatment Options ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Prevention Methods ◽  
African Setting ◽  
Rheumatic Heart

Poststreptococcal complications, such as acute rheumatic fever (ARF) and rheumatic heart disease (RHD), are common in resource-limited settings, with RHD recognised as the most common cause of paediatric heart disease worldwide. Managing these conditions in resource-limited settings can be challenging. We review the investigation and treatment options for ARF and RHD and, most importantly, prevention methods in an African setting.

Are there any novel markers in acute rheumatic fever: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio

2020 ◽  
Vol 30 (5) ◽  
pp. 717-721
Author(s):  
Dilek Giray ◽  
Olgu Hallioglu
Keyword(s):  
Heart Disease ◽  
Rheumatic Fever ◽  
Sedimentation Rate ◽  
Acute Rheumatic Fever ◽  
Cardiac Involvement ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Rheumatic Heart

AbstractObjective:The aim of this study was to investigate the relationship between C-reactive protein and erythrocyte sedimentation rate and neutrophil-to-lymphocyte, platelet-to-lymphocyte, and monocyte-to-lymphocyte ratios in acute rheumatic fever in children.Method:In this retrospective study, 182 patients with acute rheumatic fever and 173 controls were included. Complete blood count parameters, and neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were recorded for all the patients underwent transthoracic echocardiography.Results:Neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were significantly higher in patients with rheumatic heart disease than patients without cardiac involvement (p < 0.05). C-reactive protein and erythrocyte sedimentation rate levels were found to have a positive correlation with neutrophil-to-lymphocyte (r = 0.228, p = 0.001; r = 0.355, p = 0.001), platelet-to-lymphocyte (r = 0.227, p = 0.01; r = 0.149, p = 0.005), and monocyte-to-lymphocyte ratios (r = 0.117, p = 0.005; r = 0.107, p = 0.044). Cardiac involvement was present in 152 (83.5%) of the patients. Neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were significantly higher in patients with rheumatic heart disease than patients without cardiac involvement (p < 0.05). Patients with carditis were grouped according to mitral, aortic, or both valve involvement but there was no significant difference between the groups with respect to neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios. In addition, neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios were significantly higher in patients with Sydenham’s chorea than without chorea (p < 0.05).Conclusion:Neutrophil-to-lymphocyte, platelet-to-lymphocyte, and monocyte-to-lymphocyte ratios may help make the diagnosis of acute rheumatic fever and its prognosis by serial measurements in follow-up but none of them tell us the severity of carditis. Also, this is the first study showing the positive correlation between Sydenham’s chorea and neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios. Further studies are needed to confirm this hypothesis, as this is the first study in the literature on this topic.

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