Rheumatic heart disease remains a critical yet preventable public health issue, particularly in low- and middle-income countries and in marginalised or Indigenous communities. It is characterised by chronic structural and functional changes in the heart, predominantly affecting the valves, and typically arises from repeated episodes of RF. Rheumatic fever itself is an autoimmune inflammatory reaction triggered by infections of the throat or skin caused by Streptococcus pyogenes.
Globally, RHD affects approximately 55 million people, contributing to 360,000 deaths in 2021. The disease continues to be endemic in regions such as sub-Saharan Africa, the Middle East, South Asia, tropical Latin America, and the South Pacific, with women showing a higher prevalence in most regions. Effective and timely interventions are essential to preventing premature morbidity and mortality associated with RHD.
Professor Zühlke emphasised the importance of the guidelines, stating, “These evidence-based guidelines are a landmark, coming nearly 20 years after the last consensus-based recommendations. We anticipate they will improve care and quality of life for over 50 million people living with RHD, the vast majority in low- and middle-income countries.”
The WHO guidelines provide evidence-based recommendations for the prevention and management of RF and RHD. These encompass the identification and treatment of suspected group A Streptococcus infections, long-term antibiotic prophylaxis to prevent recurrence, and treatment of RF-related inflammation using anti-inflammatory medication. They also promote adherence to interventions and advocate for early screening to detect RHD.
