RHD is the scourge of mankind . While a part of the world is suffering from glamorous lifestyle disease ,a significant population (The country I live – India , included) is suffering due to “lack of any style” in their life ! exposed to primitive streptococcal infections and end up in deadly destructive heart valve disease .
While , the privileged cardiologists make merry in cath labs , a few toil in the deep sub Sahara forests and the tropics of Cambodia to bring some sense and balance to cardiology literature.
Mankind will benefit much more these committed souls* than the pseudo-research that is happening world wide !
Of course , we should thank the NEJM to publish such precious articles !
The summary of this article goes something like this
Echocardiography , if used widely in general population ( more specifically in children) can identify rheumatic fever early with high degree of precision .With penicillin prophylaxis we can reduce the RHD burden of our planet significantly.
The message may be simple, but in the modern world people’s suffering is not due to lack of sophisticated health tools , but “lack of common sense “
This article came in 2007, unfortunately it has not generated the desired impact among the cardiac care takers .(While a mediocre , drug eluting stent can reach 1000 cath labs in 100 countries in a matter of weeks!)
The World health organisation (WHO) is yet to formally adopt this new echocardiographic criteria to diagnose Rheumatic fever .We expect the WHO , to urgently formulate new guidelines for early detection of rheumatic fever .(It is better , we stop hanging on to Jones for over half century !)
Will the WHO be proactive ?
If a portable echo costing few thousand dolors can save millions of life , let the WHO the bring an ordinance to supply (liberally ) manpower and machines to all those poor countries which lack in basic health service , but infested with free supply of deadly land mines , outsourced arms and ammunition !
This study was performed in Maputo Heart Institute Mozambique , and Cambodia .
http://www.nejm.org/doi/full/10.1056/NEJMoa065085
http://circ.ahajournals.org/cgi/reprint/120/8/663
* Three cheers to Eloi Marijon, M.D., Phalla Ou, M.D., David S. Celermaje .
Travel online to Africa : A journey into human side of cardiology . . .
The charity that has adapted Maputo Heart Institute Mozambique
Dr.S.Venkatesan MD 