Rheumatic Heart Disease

Redemtor Atieno

Nairobi, Kenya – Oct 2007

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A sore throat that hurts when you swallow and gives you a fever may be ignored; one may take a pain killer and hope it goes away. But this common ailment may be the early symptoms of a more serious medical problem known as rheumatic heart disease. At least 200,000 new cases of the disease are diagnosed in Kenya annually.

Treating the sore throat promptly with an appropriate antibiotic only costs around Kshs 200. This amount may save one from open heart surgery which costs upwards of Ksh 350,000.

The executive director of the Kenyan Heart National Foundation (KHNF) ‘Elizabeth Gatumia’ says rheumatic heart disease is a disease of the poor that can be prevented by utilising simple and low cost measures.

The disease is common among school children living in disadvantaged areas. Gatumia says the condition is of great concern in poor and overcrowded communities and that untreated infections damage the hearts of many children. By their late teens or early 20’s they will need expensive valve replacement surgery at the most productive stage or prime of their lives.

She says the World Heart Federation (WHF) is encouraging all National Heart Foundations to start concentrating more on prevention of the disease. Treatment is very expensive however, it is hoped that campaigns on prevention will lead to it being curbed, as has been found with other diseases such as HIV/Aids.

“We are heavily targeting children in our campaigns, if we don’t do that our country may easily lose an entire generation before we realise” she laments. Rheumatic heart disease starts as a sore throat caused by viruses but sometimes caused by bacteria called Streptococcus (strep). With an incubation period ranging from one to ten years it progresses to rheumatic fever and eventually to the full blown disease.

According to the Kenyan Heart National Foundation (KHNF) a child with a strep sore throat may suddenly develop a high fever. The back of the child’s mouth and tonsils become very red and swollen, the lymph nodes on the child’s neck become enlarged, tender and painful. Usually a runny nose or coughing are not part of the symptoms.

Prompt and effective treatment of a strep sore throat with appropriate medication prevents the child from acquiring rheumatic fever and curbs the infection from spreading to others at home and or school.

If a ‘strep’ sore throat is not treated properly a child may get rheumatic fever within two weeks. It is typically accompanied by painful and swollen joints, and sometimes the pain will move from one joint to another.

(KHNF) says a child with rheumatic fever must be treated immediately with an injection of benzathine penicillin and aspirin. Recuperation from rheumatic fever takes a long time and could lead to, the child being bedridden for a month or more.

Rheumatic heart disease is characterized by leaking of damaged heart valves. Symptoms include shortness of breath, weakness and an irregular heart beat especially after strenuous physical activity or exercise. The person suffering from the disease may also have a heart murmur and often can’t sleep at night. (KHNF) states that the conditions associated with rheumatic heart disease can worsen over time and the afflicted person may become physically disabled and may even die prematurely.

It is due to the seriousness of this disease that the Kenyan Heart National Foundation and its partner the Danish Heart Foundation have started an ambitious program funded by the Danish Development Agency (DANIDA) to stop the spread of rheumatic heart disease in Kenya.

(KHNF) has been running a rheumatic heart disease prevention campaign in Mathare and Mukuru slums and its environs for the past year. It is also creating awareness on the prevention of rheumatic heart disease through sensitization and training seminars of various groups/ individuals (e.g. teachers, nurses, clinicians etc) within pilot project areas in parts of Nairobi Eastlands. “If teachers can identify the symptoms of a strep sore throat at an early stage, they can send children to clinics early and save them from rheumatic heart disease,” says Gatumia.

Gatumia says (KHNF) has also painted Kenyan Heart Talking walls in schools. The talking walls present illustrations that show the four major symptoms of the disease; it is hoped they will help to raise further awareness amongst children.

This years World Hearts Day will be held on the 29th September at the splash grounds in Nairobi. Gatumia says it will be a fun day with fundraising activities and awareness campaigns about the symptoms of the disease. This year’s theme is “team up for healthy hearts”.

World hearts day is run by the World Heart Federations member organizations in over 100 countries.