Kerala is yet again on a threshold of achieving a milestone in health care. This time the goal is to reduce rheumatic heart disease (RHD) and eliminate rheumatic fever (RF) by 2020.
The target has been set by the Rheumatic Heart Club Kerala (RHCK), an NGO working in Kerala for the prevention and control of RF and RHD since 1997. The World Heart Federation intends to reduce the burden of RHD and eliminate RF in developing countries by 2025.
Cardiologist Abdul Khadar, former president, RHCK, who has been working on the project, said the prevalence of RF had come down from 2.6 per 1,000 population in early 1970s to 0.1 per 1,000 in 2014.
“We had only 82 cases of RF in 2014 and fewer cases were reported in 2015 and 2016,” Dr. Khadar said.
Vulnerable areas
The number of cases this year is yet to ascertained but no cases have been reported from the Kottayam, Alappuzha, and Ernakulam medical colleges, Dr. Khadar said.
There are certain pockets in the State such as Poovar in Thiruvananthapuram and Ponnani in Malappuram where RF is still being reported. By concentrating on areas like these the RHCK could achieve its goal easily.
Much of the decline in RHD may be a reflection of the improved primary health care in the State, said R. Krishna Kumar, vice chairman, World Heart Federation (WHF).
RHD is preventable and the WHF has come up with a roadmap on reducing the cardiovascular morbidity and mortality through prevention and control of RHD, he said.
Dr. Khader said the RHCK brought out booklets to make Anganwadi workers aware of the disease and conducted contact programmes at school. It was important that proper diagnosis, prevention and treatment of rheumatic fever were done to reduce the burden of RHD, he said.
The cause
The streptococus bacteria infects the upper respiratory system (throat infection, toncillitis) which could result in RF and later RHD or arthritis. The tissues commonly affected could be heart valves and body joints.
According to WHO protocols, children who get RF have to be treated with penicillin injection every third week for five years. If children develop carditis along with RF, the injections have to be taken till they are 25 years old.
