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The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study

BACKGROUND: Rheumatic heart disease (RHD) is a major cause of premature death in low and middle-income countries. The greatest barrier to RHD control is neglect of the disease in national health policies and a lack of prevalence data that might inform control efforts. Myanmar is making remarkable pr...

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Autores principales: Myint, Nan Phyu Sin Toe, Aung, Ne Myo, Win, Myint Soe, Htut, Thu Ya, Ralph, Anna P., Cooper, David A., Nyein, Myo Lwin, Kyi, Mar Mar, Hanson, Josh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821331/
https://www.ncbi.nlm.nih.gov/pubmed/29466408
http://dx.doi.org/10.1371/journal.pone.0192880
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author Myint, Nan Phyu Sin Toe
Aung, Ne Myo
Win, Myint Soe
Htut, Thu Ya
Ralph, Anna P.
Cooper, David A.
Nyein, Myo Lwin
Kyi, Mar Mar
Hanson, Josh
author_facet Myint, Nan Phyu Sin Toe
Aung, Ne Myo
Win, Myint Soe
Htut, Thu Ya
Ralph, Anna P.
Cooper, David A.
Nyein, Myo Lwin
Kyi, Mar Mar
Hanson, Josh
author_sort Myint, Nan Phyu Sin Toe
collection PubMed
description BACKGROUND: Rheumatic heart disease (RHD) is a major cause of premature death in low and middle-income countries. The greatest barrier to RHD control is neglect of the disease in national health policies and a lack of prevalence data that might inform control efforts. Myanmar is making remarkable progress against many infectious diseases, but there are almost no data to define the clinical burden of RHD in the country. This prospective audit was performed in an adult medical ward of a tertiary-referral hospital in Yangon, to gain an insight into the prevalence of RHD in Myanmar. PRINCIPAL FINDINGS: All patients admitted to the ward between May 1, 2016 and April 30, 2017 were eligible for enrolment. RHD was confirmed in 96 patients who were admitted on 134 occasions, representing 1.1% of the 12,172 adult medical admissions during the study period. This compared with 410 (3.4%) admissions with HIV and 14 (0.1%) with malaria. Patients with RHD had a median age of 44 years (interquartile range: 35–59); 70 (73%) were female. Only one patient had ever had surgery despite 79 (82%) meeting criteria for intervention; 54 (56%) patients were not receiving any regular clinician review. Prior to hospitalisation only 18 (19%) patients were receiving regular penicillin. Only 8 (19%) of the 42 women <50 years were using contraception. Of 49 patients who had been hospitalised previously, 22 (45%) were receiving no regular therapy. During the study three (3.1%) patients died, and 28 (29%) were lost to follow-up. Of the 65 (68%) alive and retained in care, 21 (32%) were still experiencing moderate-severe RHD-related symptoms at the study’s end. CONCLUSIONS: There is a significant and unmet clinical burden of RHD in Myanmar. A national RHD programme would improve patient care, reducing morbidity and mortality from this preventable disease.
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spelling pubmed-58213312018-03-02 The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study Myint, Nan Phyu Sin Toe Aung, Ne Myo Win, Myint Soe Htut, Thu Ya Ralph, Anna P. Cooper, David A. Nyein, Myo Lwin Kyi, Mar Mar Hanson, Josh PLoS One Research Article BACKGROUND: Rheumatic heart disease (RHD) is a major cause of premature death in low and middle-income countries. The greatest barrier to RHD control is neglect of the disease in national health policies and a lack of prevalence data that might inform control efforts. Myanmar is making remarkable progress against many infectious diseases, but there are almost no data to define the clinical burden of RHD in the country. This prospective audit was performed in an adult medical ward of a tertiary-referral hospital in Yangon, to gain an insight into the prevalence of RHD in Myanmar. PRINCIPAL FINDINGS: All patients admitted to the ward between May 1, 2016 and April 30, 2017 were eligible for enrolment. RHD was confirmed in 96 patients who were admitted on 134 occasions, representing 1.1% of the 12,172 adult medical admissions during the study period. This compared with 410 (3.4%) admissions with HIV and 14 (0.1%) with malaria. Patients with RHD had a median age of 44 years (interquartile range: 35–59); 70 (73%) were female. Only one patient had ever had surgery despite 79 (82%) meeting criteria for intervention; 54 (56%) patients were not receiving any regular clinician review. Prior to hospitalisation only 18 (19%) patients were receiving regular penicillin. Only 8 (19%) of the 42 women <50 years were using contraception. Of 49 patients who had been hospitalised previously, 22 (45%) were receiving no regular therapy. During the study three (3.1%) patients died, and 28 (29%) were lost to follow-up. Of the 65 (68%) alive and retained in care, 21 (32%) were still experiencing moderate-severe RHD-related symptoms at the study’s end. CONCLUSIONS: There is a significant and unmet clinical burden of RHD in Myanmar. A national RHD programme would improve patient care, reducing morbidity and mortality from this preventable disease. Public Library of Science 2018-02-21 /pmc/articles/PMC5821331/ /pubmed/29466408 http://dx.doi.org/10.1371/journal.pone.0192880 Text en © 2018 Myint et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Myint, Nan Phyu Sin Toe
Aung, Ne Myo
Win, Myint Soe
Htut, Thu Ya
Ralph, Anna P.
Cooper, David A.
Nyein, Myo Lwin
Kyi, Mar Mar
Hanson, Josh
The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study
title The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study
title_full The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study
title_fullStr The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study
title_full_unstemmed The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study
title_short The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study
title_sort clinical characteristics of adults with rheumatic heart disease in yangon, myanmar: an observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821331/
https://www.ncbi.nlm.nih.gov/pubmed/29466408
http://dx.doi.org/10.1371/journal.pone.0192880
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