The results of a large-scale study, completed in Uganda and published in the New England Journal of Medicine on Nov. 12, show that penicillin, a widely used, low-cost antibiotic, is useful in the treatment of acute rheumatic fever in children and adults its relapse.
“Our study found that penicillin can prevent a latent rheumatic heart disease from progressing to the more severe, irreversible valve damage that is common in our hospitals with little or no access to valve surgery,” said the head of the Cardiology at the Uganda Heart Institute, Dr. Emmy Okello.
can further damage a child’s heart, “she added.
Although largely in developed countries through the rapid and successful treatment of strep bacteria, also known as strep throat rheumatic fever are eradicated, the disease remains widespread in sub-Saharan Africa.
“We know from previous studies that sub-Saharan Africa continues to have the most people with rheumatic heart disease and most people die from it.” said Craig Sable, assistant director of cardiology at Children’s National Hospital in Washington, DC and co-senior author of the study.
This is the first modern randomized controlled trial of rheumatic heart disease. “The results are incredibly important in and of themselves, but they also show that high quality clinical trials are feasible to treat this neglected cardiovascular disease,” said Andrea Beaton, Associate Professor of Cardiology at Cincinnati Children’s Hospital.
The study, nicknamed Gwoko Adunu pa Lutino, which means “protecting the heart of a child”, involved 818 Ugandan children and adolescents aged five to 17, one of whom was latent Rheumatic heart disease was diagnosed to see if an injection of penicillin was effective in preventing their heart disease from getting worse.
“There are many challenges in recruiting and retaining study participants in areas like our study region in Uganda. It is important to overcome barriers, however, as we need to study these treatments in those most severely affected by the disease to understand how they and others like them can benefit from the results, “said Dr. Sable.
The study was led by an international panel of pediatric heart experts from the Cincinnati Children’s Medical Center, the Uganda Heart Institute and the Murdoch Children’s Research Institute in Melbourne, Australia.
Of the 799 participants who completed the study who received prophylactic penicillin injection (399 volunteers), three participants showed signs of exacerbated rheumatic heart disease. In contrast, 33 of the 400 volunteers in the control group showed signs of worsening rheumatic heart disease Those who received no treatment had a similar progression in echocardiogram results.
The results were presented in a special presentation at the Scientific Sessions of the American Heart Association on the same day that the results were published in the New England Journal of Medicine were.