Recent Advances in the Rheumatic Fever and Rheumatic Heart Disease Continuum

• Published in: Pathogens (Basel) Vol. 11; no. 2; p. 179
• Main Authors: Rwebembera, Joselyn, Nascimento, Bruno Ramos, Minja, Neema W, de Loizaga, Sarah, Aliku, Twalib, Dos Santos, Luiza Pereira Afonso, Galdino, Bruno Fernandes, Corte, Luiza Silame, Silva, Vicente Rezende, Chang, Andrew Young, Dutra, Walderez Ornelas, Nunes, Maria Carmo Pereira, Beaton, Andrea Zawacki
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 28.01.2022; MDPI
• Subjects: 20th century; advances; Antibiotics; Big Data; Cardiovascular disease; Cardiovascular diseases; Coronary artery disease; Disease prevention; Epidemiology; Fever; Heart diseases; Heart failure; High income; HIV; Human immunodeficiency virus; Infectious diseases; Mortality; Pandemics; Penicillin; Pharyngitis; Prophylaxis; Public health; Review; Rheumatic fever; Rheumatic heart disease; Tropical diseases; Vaccine development; Australia; Africa; India; rheumatic fever; advances; rheumatic heart disease
• ISSN: 2076-0817; 2076-0817
• DOI: 10.3390/pathogens11020179

Nearly a century after rheumatic fever (RF) and rheumatic heart disease (RHD) was eradicated from the developed world, the disease remains endemic in many low- and middle-income countries (LMICs), with grim health and socioeconomic impacts. The neglect of RHD which persisted for a semi-centennial was further driven by competing infectious diseases, particularly the human immunodeficiency virus (HIV) pandemic. However, over the last two-decades, slowly at first but with building momentum, there has been a resurgence of interest in RF/RHD. In this narrative review, we present the advances that have been made in the RF/RHD continuum over the past two decades since the re-awakening of interest, with a more concise focus on the last decade's achievements. Such primary advances include understanding the genetic predisposition to RHD, group A (GAS) vaccine development, and improved diagnostic strategies for GAS pharyngitis. Echocardiographic screening for RHD has been a major advance which has unearthed the prevailing high burden of RHD and the recent demonstration of benefit of secondary antibiotic prophylaxis on halting progression of latent RHD is a major step forward. Multiple befitting advances in tertiary management of RHD have also been realized. Finally, we summarize the research gaps and provide illumination on profitable future directions towards global eradication of RHD.