To coincide with National Rheumatic Fever Week in South Africa – which this year takes place from 01-06 August – the South African Medical Journal has published two articles and a letter focusing on rheumatic fever and rheumatic heart disease.
 
In his guest editorial Professor Bongani Mayosi of the University of Cape Town (UCT) notes that National Rheumatic Fever Week was initially established over 25 years ago to ‘focus the attention of the nation on the need to implement proven interventions to reduce the incidence of acute rheumatic fever (ARF) and the prevalence of rheumatic heart disease (RHD).’

He recognizes progress achieved through the ASAP Programme during this time, and emphasises the feasibility of eradicating ARF and ending rheumatic heart disease RHD, citing the endorsement by African heads of state of the Addis Ababa Communiqué, which sets out seven actions for addressing barriers to RHD control.
 
Professor Mayosi, along with Geoffrey Madeira and Ana Olga Mocumbi of the Chronic NCD Division in the Ministry of Health of Mozambique, also recently sent a letter to the journal’s editor, noting the problem of pain caused by the intramuscular injection of BPG. BPG is the essential antibiotic for secondary prevention of ARF and primary prevention of ARF in children and young adults with pharyngitis. This pain can deter patients from receiving future injections, thus reducing adherence and increasing the risk of recurrent rheumatic fever.

The authors cite a randomised trial whose results suggest that using a local anaesthetic agent – lignocaine hydrochloride – as a diluent for BPG in place of water, significantly reduces the pain felt by patients during injections.

Also published in the South African Medical Journal this week was an article assessing ‘whether, and how, asymptomatic chronic health conditions in schoolchildren could be addressed’.

In an article entitled ‘Asymptomatic rheumatic heart disease in South African schoolchildren’, authors Dr Shung-King, Dr Zuhlke, Dr Engel and Professor Mayosi examine the data from two random screenings of a total of 2720 schoolchildren, conducted in Ethiopia and South Africa.

A high prevalence of RHD was detected in asymptomatic children, however the authors emphasised that many questions remained regarding how – and whether – large numbers of individuals could be screened for asymptomatic chronic conditions.

While acknowledging that ‘improvement in socioeconomic circumstances is the core to eradication’ of RHD, the authors stated that huge progress can nevertheless be made through  education and health promotion efforts aimed at parents and caregivers, while simultaneously strengthening health care delivered through school systems.

Stay tuned for a wrap-up of the week’s activities in South Africa early next week.

For more information:
The Heart and Stroke Foundation South Africa