Rheumatic Heart Disease in Africa
Heart disease is a significant burden across the world. From the Americas to Africa, heart disease affects people globally. While heart disease affects people from all spectrums of the socio-economic ladder, it disproportionately influences the lives of those living in extreme poverty. Nowhere is this more apparent than with rheumatic heart disease in Africa.

What is Rheumatic Heart Disease?

Rheumatic fever is the precursor to rheumatic heart disease. Rheumatic fever affects the connective tissue in multiple areas of the body, particularly the heart. Prolonged exposure to the illness can cause rheumatic heart disease due to the heart valves becoming swollen and scarred. Over time, this can lead to heart failure. Undertreated or ignored strep throat is the precursor to rheumatic fever. Those with frequent bouts of strep infections are at an increased risk of contracting rheumatic fever, particularly children. Children between the ages of 5 to 15 are particularly susceptible to rheumatic fever. Rheumatic fever and by extension, rheumatic heart disease, mainly affects children in underdeveloped nations.

Rheumatic Heart Disease in Africa: The Facts

Sub-Saharan Africa has the highest number of rheumatic heart disease cases in children between 5 to 14, with 1,008,207 cases.  In developed countries, the number of cases is drastically lower, with 33,330 cases. Thankfully, rheumatic heart disease is an easily preventable disease. Consistent, long-term treatment with penicillin can prevent rheumatic fever from progressing into rheumatic heart disease. Rheumatic fever is avoidable with early treatment of strep throat. This leaves the main reasons for the spread of rheumatic heart disease as a lack of resources, money and lack of knowledge about preventative measures.

How to Fight Rheumatic Heart Disease in Africa?

A multitude of nongovernmental organizations lent their services to the fight against rheumatic heart disease in Africa. One of these NGOs is the World Heart Federation (WHF), a group that dedicates itself to the eradication of rheumatic heart disease. On May 25, 2018, the global community put the World Health Organization’s resolution on rheumatic fever and rheumatic heart disease into action, and this led to the creation of the WHF Rheumatic Heart Disease Taskforce (RHDTF). This task force comprises three separate groups. The first group is the Access to Surgery group, which, as the name implies, focuses on developing strategies to bring lifesaving surgery to low-income countries. The Access to Surgery group works to create surgical centers dedicated to rheumatic heart disease surgery. The second and third groups in this task force are the Policy and Advocacy group and the Prevention and Control group. The Policy and Advocacy group works to increase access to penicillin in low-income areas by dealing with red-tape that can often affect the supply of penicillin. The Prevention and Control group focuses more on investing in projects that take on rheumatic heart disease at the local level.

The Future of Rheumatic Heart Disease

The future looks brighter for those suffering from rheumatic heart disease in Africa. Rheumatic heart disease is entirely preventable, with conventional prevention techniques such as avoiding sharing drinks, coughing away from others and even making sure to frequently wash hands.  With the help of NGOs like WHF and countries like Ghana hosting World Heart Day to raise awareness for rheumatic heart disease, there is hope that this disease’s days are finite.

Ryan Holman
Photo: Flickr

Common Diseases in MacedoniaMacedonia, officially called The Former Yugoslav Republic of Macedonia by the U.N., has a population of 2.1 million. The life expectancy for men is 73 years and the life expectancy for women is 77 years. The “healthy life expectancy” in Macedonia, the number of years a person can expect to live in good health, is only 63 years. This significantly lower age is the result of common diseases in Macedonia.

The most common causes of death in Macedonia are circulatory diseases and cancer. Circulatory diseases, specifically cerebrovascular diseases and ischemic heart disease, are responsible for more than half the deaths in Macedonia, with a mortality rate of 57.2 percent. Cancer is the second most common cause of death, with a much lower mortality rate of 19.7 percent.

An important trend to notice regarding common diseases in Macedonia is that the deadliest diseases are noncommunicable. Injuries and communicable diseases also contribute to death rates, but not nearly as many deaths as noncommunicable diseases.

Public health officials in Macedonia have put emphasis on addressing circulatory diseases in Macedonia, as they have a high mortality and disability rate.

In 2007, the Ministry of Health in Macedonia adopted an extensive health strategy that outlined several plans for improving the healthcare system in Macedonia by 2020. Addressing noncommunicable diseases in Macedonia will require efforts on behalf of the government, non-governmental institutions, healthcare institutions and the citizens of Macedonia.

The strategy for reducing the morbidity, disability and premature mortality attributed to circulatory diseases will address primary, secondary and tertiary prevention. Primary prevention will include promoting healthy lifestyles that include regular exercise, proper nutrition and smoking reduction. Secondary prevention efforts include earlier detection for circulatory diseases. Tertiary prevention includes proper care and rehabilitation for patients facing these diseases.

On World Heart Day (September 29) 2013, Shaban Mehmeti, the Director of the Institute of Public Health of Macedonia, emphasized the importance of reducing the risk for cardiovascular diseases. Mehmeti pointed out that lifestyle changes can help prevent common risk factors for cardiovascular diseases such as high blood pressure, high cholesterol, high blood sugar, being overweight and physical inactivity. Reducing the incidence of cardiovascular diseases will reduce healthcare costs and improve the quality of life in Macedonia.

Macedonia’s cross-sectoral approach to addressing circulatory diseases along with the multiple levels of prevention will hopefully reduce the incidence of circulatory diseases and will also serve as a framework for addressing other common diseases in Macedonia.

Christiana Lano

Photo: Flickr