Researchers developed new cost-effective control tool in rheumatic heart disease management

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A new tool used in determining a cost-effective mechanism of controlling rheumatic heart disease(RHD)has been developed by researchers from the University of Washington. Although, there are drugs and surgical procedures known for the management and prevention of the disease, there prices are expensive and this made its usage limited in resource to poor community.

According to current postulations, there exist about 32 million cases of rheumatic heart disease (RHD) globally with almost 275,000 deaths annually.

It is known that improper management of strep throat does lead to acute rheumatic fever (ARF) and RHD. The swelling that follows ARF can cause damage to the heart valves, ultimately leading to congestive heart failure, stroke, and loss of life. Successful antibiotic, treatment of previous infections and prophylactic antibiotic, treatment of individuals with a history of ARF or RHD do prevent disease progression, and valve surgery can prevent and treat heart failure.

As a result of the underlying guidelines on which prevention and treatment options are affordable and cost-effective, David Watkins and colleagues desire to make an economic evaluation tool that provides guidance on how to choose among various interventions and allocate resources to control programs. They were of the view that the tool will help to integrate ARF/RHD priorities within the recent commitment to provide universal health coverage in Africa.

In demonstrating its usage, the team applied it to a hypothetical African country where they considered three general interventions to reduce RHD: scaling up primary prevention (PP) services to improve treatment of pharyngitis in primary care settings; scaling up secondary prevention (SP) services to create and maintain a registry of individuals with a history of ARF or RHD who then receive prophylactic penicillin on a regular basis; or increasing coverage of heart valve surgery (VS), either by building a surgical center in country or by sending affected individuals for surgery abroad.

The researchers based the hypothetical study on some of assumptions and linked uncertainties thereby making the study illustrative rather than prescriptive. However, there are some general submissions: RHD prevention is probably more cost-effective than RHD treatment (i.e.by surgery), and PP in particular is likely to be cost-saving in the longterm. Increasing access to VS could be cost-effective in some settings, though sending affected individuals abroad for surgery would be less costly than building surgical centers in country.

The researchers recognize that low-income countries have a large number of competing health priorities and limited resources, and that priority should usually be given to the most effective and less costly interventions. Nonetheless, for the hypothetical country studied here, they say their “analysis suggests that PP would be very effective and relatively inexpensive and could easily be included in any list of first-priority interventions”.

Source
A Cost-Effectiveness Tool to Guide the Prioritization of Interventions for Rheumatic Fever and Rheumatic Heart Disease Control in African Nations, David Watkins, Solomon J. Lubinga, Bongani Mayosi, Joseph B. Babigumira, PLOS, doi: 10.1371/journal.pntd.0004860, published online 11 August 2016. Adapted from MNT Bulletin