PDF(Pubmed)
Abstract：
UNASSIGNED: Rheumatic heart disease (RHD) is a preventable sequelae of group A beta hemolytic streptococcal infection leading to an immune reaction: acute rheumatic fever (ARF) and progressive heart valve dysfunction. RHD is the leading cause of acquired heart disease in children and young adults in Sudan and many low/middle-income countries. In 2018, the World Health Organization (WHO) issued a resolution for RHD mandating that each country adopt updated guidelines for ARF and RHD management. These current guidelines are mainly directed to primary healthcare workers.
UNASSIGNED: Sudan\'s Federal Ministry of Health (FMOH) in collaboration with the WHO East Mediterranean Regional Office (EMRO) assembled a committee for updating RHD guidelines. We conducted a systematic literature search from 2000 to 2022 in National Institute of Health Database (PubMed) under the following titles: streptococcal pharyngitis, acute rheumatic fever, rheumatic heart disease, benzathine penicillin. Best available, evidence-based practices for diagnosis and management of ARF/RHD were selected and adapted to Sudan\'s situation. The guidelines were critically appraised by the committee then endorsed to the FMOH and WHO EMRO Noncommunicable Disease Departments in January 2023. This paper describes the updated guidelines.
UNASSIGNED: Simplified algorithms are provided for diagnosis of bacterial pharyngitis including two clinical criteria: sore throat and the absence of viral symptoms in the target age group. A simplified algorithm for diagnosis and management of ARF is adopted using two levels of diagnosis: suspected case at primary level where penicillin prophylaxis is started and secondary/tertiary care where echocardiography is performed and diagnosis confirmed or excluded. Echocardiography screening is recognized as the standard method for early diagnosis of RHD; however, due to the anticipated limitations, its implementation was not adopted at this time. Streptococcal skin infection is included as a precursor of ARF and a detailed protocol for benzathine penicillin administration is described.
UNASSIGNED: The Sudan guidelines for ARF/RHD management were updated. Endorsement of these guidelines to FMOH and WHO EMRO is expected to improve control of RHD in the region.
UNASSIGNED: Sudan\'s Federal Ministry of Health (FMOH) in collaboration with the WHO East Mediterranean Regional Office (EMRO) assembled a committee for updating RHD guidelines. We conducted a systematic literature search from 2000 to 2022 in National Institute of Health Database (PubMed) under the following titles: streptococcal pharyngitis, acute rheumatic fever, rheumatic heart disease, benzathine penicillin. Best available, evidence-based practices for diagnosis and management of ARF/RHD were selected and adapted to Sudan\'s situation. The guidelines were critically appraised by the committee then endorsed to the FMOH and WHO EMRO Noncommunicable Disease Departments in January 2023. This paper describes the updated guidelines.
UNASSIGNED: Simplified algorithms are provided for diagnosis of bacterial pharyngitis including two clinical criteria: sore throat and the absence of viral symptoms in the target age group. A simplified algorithm for diagnosis and management of ARF is adopted using two levels of diagnosis: suspected case at primary level where penicillin prophylaxis is started and secondary/tertiary care where echocardiography is performed and diagnosis confirmed or excluded. Echocardiography screening is recognized as the standard method for early diagnosis of RHD; however, due to the anticipated limitations, its implementation was not adopted at this time. Streptococcal skin infection is included as a precursor of ARF and a detailed protocol for benzathine penicillin administration is described.
UNASSIGNED: The Sudan guidelines for ARF/RHD management were updated. Endorsement of these guidelines to FMOH and WHO EMRO is expected to improve control of RHD in the region.
摘要：
风湿性心脏病（RHD）是A组β溶血性链球菌感染可预防的后遗症，可导致免疫反应：急性风湿热（ARF）和进行性心脏瓣膜功能障碍。RHD是苏丹和许多低收入/中等收入国家儿童和年轻人获得性心脏病的主要原因。2018年，世界卫生组织（WHO）发布了一项关于RHD的决议，要求每个国家采用更新的ARF和RHD管理指南。这些当前指南主要针对初级卫生保健工作者。
苏丹联邦卫生部（FMOH）与世卫组织东地中海区域办事处（EMRO）合作组建了一个委员会，以更新RHD指南。从2000年到2022年，我们在美国国立卫生研究院数据库（PubMed）进行了系统的文献检索，标题如下：链球菌性咽炎，急性风湿热,风湿性心脏病,苄星青霉素.最好的可用，选择了基于证据的ARF/RHD诊断和管理实践，并根据苏丹的情况进行了调整。委员会对准则进行了严格评估，然后于2023年1月批准了FMOH和世卫组织EMRO非传染性疾病部门。本文介绍了更新后的指南。
提供了用于诊断细菌性咽炎的简化算法，包括两个临床标准：喉咙痛和目标年龄组中没有病毒症状。采用两个诊断级别的简化算法来诊断和管理ARF：开始青霉素预防的初级疑似病例和进行超声心动图检查并确认或排除诊断的二级/三级护理。超声心动图筛查被认为是早期诊断RHD的标准方法；然而，由于预期的限制，目前尚未通过其实施。包括链球菌皮肤感染作为ARF的前体，并描述了苄星青霉素给药的详细方案。
■更新了苏丹ARF/RHD管理指南。对FMOH和世卫组织EMRO的这些准则的认可有望改善该地区对RHD的控制。
苏丹联邦卫生部（FMOH）与世卫组织东地中海区域办事处（EMRO）合作组建了一个委员会，以更新RHD指南。从2000年到2022年，我们在美国国立卫生研究院数据库（PubMed）进行了系统的文献检索，标题如下：链球菌性咽炎，急性风湿热,风湿性心脏病,苄星青霉素.最好的可用，选择了基于证据的ARF/RHD诊断和管理实践，并根据苏丹的情况进行了调整。委员会对准则进行了严格评估，然后于2023年1月批准了FMOH和世卫组织EMRO非传染性疾病部门。本文介绍了更新后的指南。
提供了用于诊断细菌性咽炎的简化算法，包括两个临床标准：喉咙痛和目标年龄组中没有病毒症状。采用两个诊断级别的简化算法来诊断和管理ARF：开始青霉素预防的初级疑似病例和进行超声心动图检查并确认或排除诊断的二级/三级护理。超声心动图筛查被认为是早期诊断RHD的标准方法；然而，由于预期的限制，目前尚未通过其实施。包括链球菌皮肤感染作为ARF的前体，并描述了苄星青霉素给药的详细方案。
■更新了苏丹ARF/RHD管理指南。对FMOH和世卫组织EMRO的这些准则的认可有望改善该地区对RHD的控制。
