Billions of US taxpayer dollars have been invested in Africa over the past 15 years to improve care for millions suffering from the HIV/AIDS epidemic, yet health systems on the continent continue to struggle. What if the investments and lessons learned from HIV could be used to improve care for those with other serious chronic conditions?
With this question in mind, researchers from Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, along with investigators and clinicians based in Uganda, borrowed an HIV/AIDS innovation to seek inroads against rheumatic heart disease in sub-Saharan Africa.
Usually beginning as strep throat, if untreated, rheumatic heart disease can result in severe heart damage, even death. Monthly, long-term penicillin shots usually slow down its progression and reduce mortality. While largely eliminated in developed countries, rheumatic heart disease leads to over 320,000 deaths each year in Africa, the Middle East, Central and South Asia, and the South Pacific.
The borrowed tool, the HIV treatment-cascade, features a series of distinct, sequential steps for assessing supplied care. The Case Western-led team recently published a study of 1,500-plus patients in Circulation: Cardiovascular Quality and Outcome describing its use in combating rheumatic heart disease, one of the earliest attempts to adapt the model for another serious illness.
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