Rheumatic Heart Disease (RHD) Programme

You are here

Rheumatic Heart Disease (RHD) Programme is run in conjunction with the Uganda Heart Institute (UHI), Case Western Reserve University, USA and JCRC. The aim is to bridge the treatment gap for RHD in Sub Saharan Africa. Interventions include secondary Penicllin prophylaxis focusing on adherence, regular clinical monitoring and management of associated complications and regular follow up echocardiography studies to monitor disease progress.

There is a component of early detection of sub clinical disease. This is through screening of primary school children to identify those who have early stages of RHD using The World Heart Federation (WHF) criteria for echocardiographic diagnosis. These children are enrolled onto the programme, started on treatment and regularly following them up. This avoids late presentation, raises awareness in the schools coupled with education on proper treatment of sore throats which when repeated and poorly treated lead to development of RHD.

To date approximately 7,000 children have been screened, treatment centres have been opened at JCRC Lubowa (100 patients) , Mbarara Hospital (70 patients), Gulu Hospital (130 patients)and the pre existing centre at UHI is also on going. Within this programme training has been conducted to facilitate care for these patients. A physician at JCRC has been trained in basic Echocardiography skills at UHI and a nurse trained to perform Electrocardiography. Basic patient management including proper administration of Benzathine, identification of heart failure and other complications such as arrhythmias and patient education on the basics of RHD.

As part of this programme, screening for RHD has been performed on children attending the HIV clinic at JCRC and the few found to have RHD have been enrolled into care at the RHD clinic as well.

As part of the Gilead trials assessment of endothelial function was performed on participants in the WAVES trial. This involved measurement of Flow Mediated Dilation (FMD) using ultrasound of the brachial artery. Training and certification of two sonographers was conducted at the University Of Wisconsin Atherosclerosis Imaging Research Programme (UWAIRP).

Currently, enrolling for a study on cardiac structure and function in chronic HIV among adults older than 45 years attending the HIV clinic at JCRC. Participants with one or more of Hypertension, Diabetes, Smoking, Elevated Cholsterol levels. Assessments include Echocardiography, EKG, and blood markers of inflammation.

JCRC CARDIAC LAB

Established under the Medtronic foundation for the care of patients with RHD it has expanded to participate in other protocols and also supplement care for patients attending JCRC who need echocardiography and EKG studies.

Capability that has been obtained includes

  • A Phillips CX50 Ultrasound scan machine with EGC capability, Adult echocardiography probe Linear probe for vascular studies.
  • A Sciller AT 102 ECG machine
  • Physician trained in limited echocardiography for research purposes
  • Nurses trained to perform ECG studies
  • A large volume HIV clinic with an aging population that is at risk of Cardiovascular disease and other NCDs