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  1. Article ; Online: Rheumatic Heart Disease Research Collaborative in Uganda.

    Okello, Emmy / Beaton, Andrea

    Circulation

    2023  Volume 147, Issue 24, Page(s) 1785–1787

    MeSH term(s) Humans ; Rheumatic Heart Disease ; Uganda
    Language English
    Publishing date 2023-06-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIRCULATIONAHA.123.063748
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A Hunter Who Hesitates to Strike May Just Get the Tail.

    Beaton, Andrea / Carapetis, Jonathan / Okello, Emmy

    Circulation

    2024  Volume 149, Issue 4, Page(s) 277–278

    MeSH term(s) Humans ; Rheumatic Fever ; Rheumatic Heart Disease
    Language English
    Publishing date 2024-01-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIRCULATIONAHA.123.065487
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Oral anticoagulation for atrial fibrillation in rheumatic heart disease.

    Dougherty, Scott / Nascimento, Bruno / Okello, Emmy

    European heart journal

    2023  Volume 44, Issue 27, Page(s) 2440–2442

    MeSH term(s) Humans ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Rheumatic Heart Disease/complications ; Blood Coagulation ; Anticoagulants/therapeutic use
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2023-07-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehad390
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  4. Article ; Online: Targeted investment needed to end rheumatic heart disease in Africa.

    Okello, Emmy / Beaton, Andrea

    The Lancet. Global health

    2021  Volume 9, Issue 7, Page(s) e887–e888

    MeSH term(s) Africa/epidemiology ; Humans ; Investments ; Rheumatic Fever ; Rheumatic Heart Disease/epidemiology ; Rheumatic Heart Disease/prevention & control
    Language English
    Publishing date 2021-05-10
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 2723488-5
    ISSN 2214-109X ; 2214-109X
    ISSN (online) 2214-109X
    ISSN 2214-109X
    DOI 10.1016/S2214-109X(21)00215-1
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  5. Article ; Online: Rheumatic Heart Disease: JACC Focus Seminar 2/4.

    Dougherty, Scott / Okello, Emmy / Mwangi, Jeremiah / Kumar, Raman Krishna

    Journal of the American College of Cardiology

    2023  Volume 81, Issue 1, Page(s) 81–94

    Abstract: It is a sad reality that although eminently preventable, and despite possessing such knowledge for >70 years, rheumatic heart disease (RHD) remains the most common cause of cardiovascular morbidity and early mortality in young people worldwide. A disease ...

    Abstract It is a sad reality that although eminently preventable, and despite possessing such knowledge for >70 years, rheumatic heart disease (RHD) remains the most common cause of cardiovascular morbidity and early mortality in young people worldwide. A disease of the poor, RHD is one of the most neglected diseases. Several challenges are unique to the acute rheumatic fever/RHD continuum and contribute to its persistence, including its sequestration among the poorest, its protracted natural history, the erratic availability of penicillin, and the lack of a concerted effort in endemic regions. However, there is cause for optimism following a resurgence in scientific interest over the last 15 years. This review presents the latest advancements in epidemiology, diagnosis, and management. It also discusses pressing research questions on disease pathophysiology, the barriers to implementation of effective management strategies, and pragmatic policy solutions required for translation of current knowledge into meaningful action.
    MeSH term(s) Humans ; Adolescent ; Rheumatic Heart Disease/diagnosis ; Rheumatic Heart Disease/epidemiology ; Rheumatic Heart Disease/therapy ; Rheumatic Fever/diagnosis ; Rheumatic Fever/epidemiology ; Rheumatic Fever/therapy ; Disease Progression ; Penicillins ; Echocardiography/adverse effects
    Chemical Substances Penicillins
    Language English
    Publishing date 2023-01-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2022.09.050
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    Zs.MO 196: Show issues

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  6. Article ; Online: Antibiotic Prophylaxis for Latent Rheumatic Heart Disease. Reply.

    Beaton, Andrea / Okello, Emmy / Steer, Andrew C

    The New England journal of medicine

    2022  Volume 386, Issue 17, Page(s) 1673–1674

    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis ; Humans ; Rheumatic Fever/prevention & control ; Rheumatic Heart Disease/prevention & control ; Secondary Prevention
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-04-28
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc2202301
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  7. Article ; Online: Outcomes and care quality metrics for people living with rheumatic heart disease and atrial fibrillation in Uganda.

    Opara, Chinonso C / Lan, Roy H / Rwebembera, Joselyn / Okello, Emmy / Watkins, David A / Chang, Andrew Y / Longenecker, Chris T

    Heart rhythm O2

    2024  Volume 5, Issue 4, Page(s) 201–208

    Abstract: Background: Atrial fibrillation (AF) is a common complication of rheumatic heart disease (RHD) and is challenging to treat in lower-resourced settings in which RHD remains endemic.: Objective: We characterized demographics, treatment outcomes, and ... ...

    Abstract Background: Atrial fibrillation (AF) is a common complication of rheumatic heart disease (RHD) and is challenging to treat in lower-resourced settings in which RHD remains endemic.
    Objective: We characterized demographics, treatment outcomes, and factors leading to care retention for participants with RHD and AF in Uganda.
    Methods: We conducted a retrospective analysis of the Uganda national RHD registry between June 2009 and May 2018. Participants with AF or atrial flutter were included. Demographics, survival, and care metrics were compared with participants without AF. Multivariable logistic regression was used to identify factors associated with retention in care among participants with AF.
    Results: A total of 1530 participants with RHD were analyzed and 293 (19%) had AF. The median age was 24 (interquartile range 14-38) years. Mortality was similar in both groups (adjusted hazard ratio 1.183,
    Conclusion: Participants with RHD and AF in Uganda do not experience higher mortality than those without AF. Anticoagulation prescription rates are high. Although retention in care is poor among RHD participants, those with concurrent AF are more likely to be retained.
    Language English
    Publishing date 2024-02-15
    Publishing country United States
    Document type Journal Article
    ISSN 2666-5018
    ISSN (online) 2666-5018
    DOI 10.1016/j.hroo.2024.02.002
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  8. Article ; Online: Using Artificial Intelligence for Rheumatic Heart Disease Detection by Echocardiography: Focus on Mitral Regurgitation.

    Brown, Kelsey / Roshanitabrizi, Pooneh / Rwebembera, Joselyn / Okello, Emmy / Beaton, Andrea / Linguraru, Marius George / Sable, Craig A

    Journal of the American Heart Association

    2024  Volume 13, Issue 2, Page(s) e031257

    Abstract: Background: Identification of children with latent rheumatic heart disease (RHD) by echocardiography, before onset of symptoms, provides an opportunity to initiate secondary prophylaxis and prevent disease progression. There have been limited artificial ...

    Abstract Background: Identification of children with latent rheumatic heart disease (RHD) by echocardiography, before onset of symptoms, provides an opportunity to initiate secondary prophylaxis and prevent disease progression. There have been limited artificial intelligence studies published assessing the potential of machine learning to detect and analyze mitral regurgitation or to detect the presence of RHD on standard portable echocardiograms.
    Methods and results: We used 511 echocardiograms in children, focusing on color Doppler images of the mitral valve. Echocardiograms were independently reviewed by an expert adjudication panel. Among 511 cases, 229 were normal, and 282 had RHD. Our automated method included harmonization of echocardiograms to localize the left atrium during systole using convolutional neural networks and RHD detection using mitral regurgitation jet analysis and deep learning models with an attention mechanism. We identified the correct view with an average accuracy of 0.99 and the correct systolic frame with an average accuracy of 0.94 (apical) and 0.93 (parasternal long axis). It localized the left atrium with an average Dice coefficient of 0.88 (apical) and 0.9 (parasternal long axis). Maximum mitral regurgitation jet measurements were similar to expert manual measurements (
    Conclusions: Artificial intelligence has the potential to detect RHD as accurately as expert cardiologists and to improve with more data. These innovative approaches hold promise to scale echocardiography screening for RHD.
    MeSH term(s) Child ; Humans ; Mitral Valve Insufficiency/diagnostic imaging ; Rheumatic Heart Disease/diagnostic imaging ; Artificial Intelligence ; Sensitivity and Specificity ; Echocardiography/methods
    Language English
    Publishing date 2024-01-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.123.031257
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  9. Article ; Online: What We Lost in the Fire: Endemic Tropical Heart Diseases in the Time of COVID-19.

    Chang, Andrew Y / Zühlke, Liesl / Ribeiro, Antonio Luiz P / Barry, Michele / Okello, Emmy / Longenecker, Chris T

    The American journal of tropical medicine and hygiene

    2023  Volume 108, Issue 3, Page(s) 462–464

    Abstract: The COVID-19 pandemic has profoundly influenced the effort to achieve global health equity. This has been particularly the case for HIV/AIDS, tuberculosis, and malaria control initiatives in low- and middle-income countries, with significant outcome ... ...

    Abstract The COVID-19 pandemic has profoundly influenced the effort to achieve global health equity. This has been particularly the case for HIV/AIDS, tuberculosis, and malaria control initiatives in low- and middle-income countries, with significant outcome setbacks seen for the first time in decades. Lost in the calls for compensatory funding increases for such programs, however, is the plight of endemic tropical heart diseases, a group of disorders that includes rheumatic heart disease, Chagas disease, and endomyocardial fibrosis. Such endemic illnesses affect millions of people around the globe and remain a source of substantial mortality, morbidity, and health disparity. Unfortunately, these conditions were already neglected before the pandemic, and thus those living with them have disproportionately suffered during the time of COVID-19. In this perspective, we briefly define endemic tropical heart diseases, summarizing their prepandemic epidemiology, funding, and control statuses. We then describe the ways in which people living with these disorders, along with the healthcare providers and researchers working to improve their outcomes, have been harmed by the ongoing COVID-19 pandemic. We conclude by proposing the path forward, including approaches we may use to leverage lessons learned from the pandemic to strengthen care systems for these neglected diseases.
    MeSH term(s) Humans ; COVID-19 ; Pandemics ; Developing Countries ; Acquired Immunodeficiency Syndrome ; Heart Diseases ; Neglected Diseases
    Language English
    Publishing date 2023-02-06
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2942-7
    ISSN 1476-1645 ; 0002-9637
    ISSN (online) 1476-1645
    ISSN 0002-9637
    DOI 10.4269/ajtmh.22-0514
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  10. Article ; Online: Prevalence of cardiovascular risk factors in active tuberculosis in Africa: a systematic review and meta-analysis.

    Baluku, Joseph Baruch / Ronald, Olum / Bagasha, Peace / Okello, Emmy / Bongomin, Felix

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 16354

    Abstract: People with tuberculosis (TB) are at risk of major adverse cardiovascular events. We estimated the prevalence of cardiovascular risk (CVR) factors among people with active TB in Africa. This was a systematic review and meta-analysis of studies from ... ...

    Abstract People with tuberculosis (TB) are at risk of major adverse cardiovascular events. We estimated the prevalence of cardiovascular risk (CVR) factors among people with active TB in Africa. This was a systematic review and meta-analysis of studies from Africa. We searched EMBASE, MEDLINE through PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, mRCTs, Clinical trials.gov, and International Clinical Trials Registry Platform from inception to 31st December 2021. Among 110 eligible studies, 79 (238,316 participants) were included in the meta-analysis for smoking, 67 (52,793 participants) for current alcohol use, 30 (31,450 participants) for hazardous alcohol use, 51 (37,879 participants) for diabetes mellitus (DM), 19 (18,211 participants) for hypertension and 18 (13,910 participants) for obesity. The pooled prevalence was 26.0% (95% confidence interval 22.0-29.0) for smoking, 30.0% (25.0-35.0) for any current alcohol use, 21.0% (17.0-26.0) for hazardous alcohol use, 14.0% (9.0-18.0) for hypertension, 7.0% (6.0-9.0) for DM, and 4.0% (2.0-5.0) for obesity. Cost-effective strategies are needed to screen for CVR factors among people with active TB in Africa.
    MeSH term(s) Africa/epidemiology ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Heart Disease Risk Factors ; Humans ; Hypertension ; Obesity/complications ; Obesity/epidemiology ; Prevalence ; Risk Factors ; Tuberculosis/epidemiology
    Language English
    Publishing date 2022-09-29
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-20833-0
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