by Neddy Makonza | NUST, ZW

Have you ever had a sore throat? If the answer is YES, what did you do about it? Did you see a doctor or you just took some lemons or warm water? Strep throat or commonly known as sore throat is caused by group A streptococci bacteria and less commonly by other microbes.

It usually occurs in children and young adults. The infection can recede without treatment. This however has consequences as the years go by as it will lead to development of serious heart diseases. If strep throat is not treated it progresses to rheumatic fever (RF) then to rheumatic heart diseases (RHD) and finally infective endocarditis (IE). These heart diseases have a high mortality especially if discovered late.

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Treating strep throat with antibiotics can prevent rheumatic fever. Moreover, regular antibiotics (usually monthly injections) can pre- vent patients with rheumatic fever from contracting further strep infections and causing progression of valve damage. The global burden of disease caused by rheumatic fever and RHD currently falls disproportionately on children and young adults living in low-income countries like Zimbabwe and is responsible for about 233,000 deaths annually. Symptoms to watch out for risk of getting rheumatic heart disease are:

• A sore throat accompanied by tender, swollen lymph glands (nodes)

• A sore throat without cold symptoms, such as a runny nose

• A red rash that starts at the head and neck, then expands to the trunk and extremities

• Difficulty swallowing anything, including saliva

• Thick or bloody discharge from the nose

• A bright red tongue with bumps all over it, known as strawberry tongue

Acute rheumatic fever primarily affects the heart, joints and central nervous system. The major importance of acute rheumatic fever is its ability to cause fibrosis of heart valves, leading to crippling valvular heart disease, heart failure and death.

At least 15.6 million people are estimated to be currently affected by RHD with a significant number requiring repeated hospitalization. The end stage treatment is open heart surgery which is unaffordable and also unavailable in our country. Overcrowding, poor housing conditions, undernutrition and lack of access to healthcare play a role in the persistence of this disease in developing countries. The decline of rheumatic fever in developed countries is believed to be the result of improved living conditions and availability of antibiotics for treatment of group A streptococcal infection. Rheumatic heart disease and infective endocarditis are diseases that can be pre- vented if the initial causes are eradicated at the time of infection. So let us join together and have rheumatic heart disease free generation by treating sore throats.

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