The Story of Rheumatic Heart Disease in Rwanda: Capacity Building for Comprehensive Cardiovascular Care
Originating from group A streptococcus pyogenes infection (commonly strep pharyngitis or strep throat), rheumatic heart diseaseRheumatic heart disease (RHD) is the leading acquired heart disease among children, adolescents, and young adults worldwide. If left untreated or not properly managed with the appropriate antibiotic regimen, the disease can develop into an inflammatory condition, affecting critical organs, including the heart and its valves. With fulminant heart failure as part of its pathophysiology, advanced cases often require tertiary levels of care and, frequently, surgery. Unfortunately, many of these cases are seen in resource-limited settings that lack the necessary human and capital resources, making surgical intervention prohibitive. Although its history has presented unique challenges to the development of healthcare infrastructures, partnerships with humanitarian medical organizations and a global commitment to decentralized non-communicable disease (NCD) strategy, has enabled Rwanda to provide enhanced cardiovascular care, including surgery, to members of its most vulnerable population to address the burden of RHD in the country. To sustainably combat the burden of RHD, strategic investments in human resource capacity-building through comprehensive training of all involved is required. This can be done by leveraging existing partnerships and balancing local health priorities to combat this disease while considering management and mitigation of other pressing communicable and non-communicable disease burdens. To eradicate RHD, further efforts must focus on increasing public health awareness about the danger of the illness and promoting early detection and treatment of the primary infection using antibiotics. The purpose of this chapter is to chronicle Rwanda’s extraordinary achievement of advancing from a resource-destitute country with a historical context of unconscionable genocide toward an evolving ecosystem of health advances and sustainable cardiovascular care.
