Dougherty Scott, Beaton Andrea, Nascimento Bruno R, Zühlke Liesl J, Khorsandi Maziar, Wilson Nigel
Department of Internal Medicine, Ministry of Health, Belau National Hospital, Koror, Republic of Palau.
Children's National Medical Center, Cardiology, Washington DC, USA.
Ann Pediatr Cardiol. 2018 Jan-Apr;11(1):68-78. doi: 10.4103/apc.APC_135_17.
Rheumatic heart disease (RHD) has long receded as a significant threat to public health in high-income countries. In low-resource settings, however, the specter of RHD remains unabated, as exemplified by recent data from the Global Burden of Diseases Study. There are many complex reasons for this ongoing global disparity, including inadequate data on disease burden, challenges in effective advocacy, ongoing poverty and inequality, and weak health systems, most of which predominantly affect developing nations. In this review, we discuss how each of these acts as a core challenge in RHD prevention and control. We then examine key lessons learnt from successful control programs in the past and highlight resources that have been developed to help create strong national RHD control programs.
在高收入国家，风湿性心脏病（RHD）作为对公众健康的重大威胁早已消退。然而，在资源匮乏地区，风湿性心脏病的威胁依然不减，全球疾病负担研究的最新数据便是例证。造成这种持续全球差距的原因复杂多样，包括疾病负担数据不足、有效宣传面临挑战、持续存在的贫困与不平等以及薄弱的卫生系统，其中多数主要影响发展中国家。在本综述中，我们讨论这些因素如何成为风湿性心脏病预防与控制的核心挑战。接着，我们审视过去成功控制项目所汲取的关键经验教训，并着重介绍为助力创建强大的国家风湿性心脏病控制项目而开发的资源。
