Experts link sore throat to Rheumatic Heart Disease

Health experts have warned that untreated sore throats can lead to Rheumatic Heart Disease (RHD).

RHD often begins with a sore throat caused by the bacterium Streptococcus pyogenes (group A streptococcus). The condition is common in children, typically those aged between 5 and 30 years old.

Dr. Emmy Okello, a Senior Consultant Cardiologist and Director of the RHD Collaborative in Uganda stated that their goal is to prevent sore throat infections, diagnose them early, and identify stages of heart disease to treat affected children promptly.

“Many young adults are coming to the Heart Institute and other hospitals seeking funds for surgeries, often too late, as this process starts 15 to 20 years ago and how it starts is that infection of the throat that is sometimes missed and what we are trying to do is to go back and work on prevention, diagnose and treat,” he said.

Despite the high burden of Rheumatic Heart Disease (RHD) in Uganda and most sub-Saharan African countries, there has been very little investment in research training and research.

In response, Makerere University College of Health Sciences and the Uganda Heart Institute, under the Impact program, aim to build research capacities for young researchers to conduct RHD-related research, with a special emphasis on clinical trials capacity building.

The program, spearheaded by Prof. Nelson Sewankambo, Dr. Okello, Dr. James Kayima, and Dr. Andrea Beaton, a pediatric cardiologist at Cincinnati Children’s Hospital Medical Center, currently supports PhD, master's, and career development award fellows.

Dr. Okello mentioned that when children are identified early and treated with penicillin, they can return to a normal life without surgery.

“We are putting a lot of effort into detecting children and young adults early enough so that they can be given penicillin and return to normal,” he said.

Experts noted that RHD is very common in Gulu, Lira, and Kampala. However, in the western region, particularly in Mbarara and Bushenyi areas, the condition is less prevalent.

The World Health Organization encourages countries to collaborate with ministries of health to eliminate Rheumatic Fever and Rheumatic Heart Disease globally.

Sewankambo said, “The healthcare continuum needs to improve knowledge and practice in RHD. Community healthcare workers need to know about RHD and what causes it because that's where primary prevention starts.”

He further stated that the program will contribute to improving the diagnosis of RHD through research.

“We know that access to surgery is very limited for a few lucky individuals. We hope that the work done in this project will eventually impact patient management and improve outcomes,” he said.

During the Research Dissemination Conference 2024 at Kabira Country Club in Kampala, Dr. John Omagino, Executive Director of the Uganda Heart Institute, called for assigning a nurse to each primary school to diagnose sore throats and prevent children from developing RHD.

The cost of surgery for a child with Rheumatic Heart Disease is about sh50 million, which most patients cannot afford.

Omagino suggested that all hospitals must have enough penicillin, adding that sometimes there are stockouts, and called on the Ministry of Health and National Medical Stores to prioritize penicillin availability.