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Abstract：
BACKGROUND: Rheumatic heart disease (RHD) is a devastating yet preventable condition that disproportionately affects low-middle-income countries and indigenous populations in some high-income countries. Various preventive interventions have been implemented across the globe, but evidence for the effectiveness of these measures in reducing the incidence or prevalence of acute rheumatic fever and RHD is scattered. This systematic review aims to assess the effectiveness of preventive interventions and identify the strategies used to reduce the burden of RHD.
RESULTS: A comprehensive search was conducted to identify relevant studies on RHD prevention interventions including interventions for primordial, primary, and secondary prevention. Effectiveness measures for the interventions were gathered when available. The findings indicate that school-based primary prevention services targeting the early detection and treatment of Group A Streptococcus pharyngitis infection with penicillin have the potential to reduce the incidence of Group A Streptococcus pharyngitis and acute rheumatic fever. Community-based programs using various prevention strategies also reduced the burden of RHD. However, there is limited evidence from low-middle-income countries and a lack of rigorous evaluations reporting the true impact of the interventions. Narrative synthesis was performed, and the methodological quality appraisal was done using the Joanna Briggs Institute critical appraisal tools.
CONCLUSIONS: This systematic review underscores the importance of various preventive interventions in reducing the incidence and burden of Group A Streptococcus pharyngitis, acute rheumatic fever, and RHD. Rigorous evaluations and comprehensive analyses of interventions are necessary for guiding effective strategies and informing public health policies to prevent and reduce the burden of these diseases in diverse populations.
BACKGROUND: URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42020170503.
RESULTS: A comprehensive search was conducted to identify relevant studies on RHD prevention interventions including interventions for primordial, primary, and secondary prevention. Effectiveness measures for the interventions were gathered when available. The findings indicate that school-based primary prevention services targeting the early detection and treatment of Group A Streptococcus pharyngitis infection with penicillin have the potential to reduce the incidence of Group A Streptococcus pharyngitis and acute rheumatic fever. Community-based programs using various prevention strategies also reduced the burden of RHD. However, there is limited evidence from low-middle-income countries and a lack of rigorous evaluations reporting the true impact of the interventions. Narrative synthesis was performed, and the methodological quality appraisal was done using the Joanna Briggs Institute critical appraisal tools.
CONCLUSIONS: This systematic review underscores the importance of various preventive interventions in reducing the incidence and burden of Group A Streptococcus pharyngitis, acute rheumatic fever, and RHD. Rigorous evaluations and comprehensive analyses of interventions are necessary for guiding effective strategies and informing public health policies to prevent and reduce the burden of these diseases in diverse populations.
BACKGROUND: URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42020170503.
摘要：
背景：风湿性心脏病（RHD）是一种破坏性但可预防的疾病，对中低收入国家和一些高收入国家的土著人口造成了不成比例的影响。在全球范围内实施了各种预防性干预措施，但是这些措施在降低急性风湿热和RHD发病率或患病率方面的有效性的证据是分散的。本系统评价旨在评估预防性干预措施的有效性，并确定用于减轻RHD负担的策略。
结果：进行了全面搜索，以确定有关RHD预防干预措施的相关研究，包括对原始疾病的干预措施，小学,二级预防。在可用时收集干预措施的有效性措施。研究结果表明，以青霉素早期发现和治疗A组链球菌咽炎感染为目标的学校一级预防服务有可能降低A组链球菌咽炎和急性风湿热的发生率。使用各种预防策略的基于社区的计划也减轻了RHD的负担。然而,来自中低收入国家的证据有限,也缺乏报告干预措施真正影响的严格评估.进行了叙事合成，方法质量评估是使用乔安娜·布里格斯研究所的关键评估工具进行的。
结论：本系统综述强调了各种预防性干预措施在降低A组链球菌咽炎的发病率和负担方面的重要性。急性风湿热,RHD有必要对干预措施进行严格的评估和全面的分析，以指导有效的战略并为公共卫生政策提供信息，以预防和减轻这些疾病在不同人群中的负担。
背景：URL：https://www。crd.约克。AC.uk/prospro/;唯一标识符：CRD42020170503。
结果：进行了全面搜索，以确定有关RHD预防干预措施的相关研究，包括对原始疾病的干预措施，小学,二级预防。在可用时收集干预措施的有效性措施。研究结果表明，以青霉素早期发现和治疗A组链球菌咽炎感染为目标的学校一级预防服务有可能降低A组链球菌咽炎和急性风湿热的发生率。使用各种预防策略的基于社区的计划也减轻了RHD的负担。然而,来自中低收入国家的证据有限,也缺乏报告干预措施真正影响的严格评估.进行了叙事合成，方法质量评估是使用乔安娜·布里格斯研究所的关键评估工具进行的。
结论：本系统综述强调了各种预防性干预措施在降低A组链球菌咽炎的发病率和负担方面的重要性。急性风湿热,RHD有必要对干预措施进行严格的评估和全面的分析，以指导有效的战略并为公共卫生政策提供信息，以预防和减轻这些疾病在不同人群中的负担。
背景：URL：https://www。crd.约克。AC.uk/prospro/;唯一标识符：CRD42020170503。
