HELPING CONTROL RHEUMATIC HEART DISEASE IN SAMOAThe Samoan National Health Service (NHS) is stepping up efforts to prevent heart damage among children and youth; through its programme to control rheumatic heart disease in the South Pacific, the World Heart Federation is providing the NHS with tools and technical support to help. Neglected disease of povertyRheumatic heart disease has largely been eliminated in wealthy countries, but it is still the most common preventable cardiovascular disease in children and young adults in developing countries. It affects over 15 million people and kills hundreds of thousands a year, mostly from areas in Africa, Asia and the Pacific, where poverty, poor sanitation and overcrowding are common. Heavy burden for islands in the PacificPacific Island nations have a serious problem with rheumatic heart disease; in some islands, such as Samoa, the recorded prevalence is among the highest in the world. Professor Satupaitea Viali, who heads the rheumatic heart disease control programme there, reports that “Rheumatic heart disease causes much suffering for Samoan patients and their relatives. Sending patients abroad for expensive (but life-saving) surgery uses up a significant portion of the country's scarce health care resources.” Putting effective preventive measures into practiceThe rheumatic heart disease control project in Samoa focuses on the measures of secondary prevention that the World Health Organization recommends as the most effective method for controlling the disease. This involves early identification of children who have had rheumatic fever/rheumatic heart disease so that they can receive the secondary prophylaxis (monthly penicillin) that prevents recurrences. The programme in Samoa was launched with a workshop for health professionals in January 2007. Since then, approximately 4,000 Samoan children have been screened for heart murmurs by stethoscope. Of these, 900 have suspicious heart murmurs, and will need to be followed up by specialist physician and/or echocardiogram to determine if their heart murmurs are caused by valve damage from rheumatic heart disease (RHD). If they are, they will receive secondary prophylaxis to prevent the streptococcal infections that cause recurrences of rheumatic fever, thereby preventing the progression of heart valve damage. A new electronic national RHD register will help health officials track patients and ensure that they receive proper treatment. It will also generate epidemiological information that helps health officials target and plan their work. Since the programme started officially in Jan 2007, over 570 names of people with rheumatic fever/rheumatic heart disease have been entered into the new register, and 24 more people with rheumatic fever/rheumatic heart disease have started potentially life-saving penicillin injections. Global and regional networks on RHD controlThe World Heart Federation rheumatic heart disease control programme in the Pacific islands is run in partnership with the Menzies School of Health Research in Darwin, Australia, the Ministry of Health in Fiji and the National Health Service in Samoa. In addition to demonstration sites in Fiji and Samoa, it invites clinicians, public health officials from neighbouring countries to regional workshops and through these is developing a regional network for RHD control. Training and educational materials and register databases used in the programme are available free of charge through the World Heart Federation’s Rheumatic Heart Disease Network (RHDnet), an online resource which may be viewed in our web site. | |||||||
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