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Article ; Online: Association between the COVID-19 pandemic and mental health in very old people in Sweden.

Jonsson, Fanny / Olofsson, Birgitta / Söderberg, Stefan / Niklasson, Johan

2024 Volume 19, Issue 4, Page(s) e0299098

Abstract: Background: During the COVID-19 pandemic, Sweden implemented social distancing measures to reduce infection rates. However, the recommendation meant to protect individuals particularly at risk may have had negative consequences. The aim of this study ... ...

Abstract	Background: During the COVID-19 pandemic, Sweden implemented social distancing measures to reduce infection rates. However, the recommendation meant to protect individuals particularly at risk may have had negative consequences. The aim of this study was to investigate the impact of the COVID-19 pandemic on very old Swedish peoples' mental health and factors associated with a decline in mental health. Methods: We conducted a cross-sectional study among previous participants of the SilverMONICA (MONItoring of Trends and Determinants of CArdiovascular disease) study. Of 394 eligible participants, 257 (65.2%) agreed to participate. Of these, 250 individuals reported mental health impact from COVID-19. Structured telephone interviews were carried out during the spring of 2021. Data were analysed using the χ2 test, t-test, and binary logistic regression. Results: Of 250 individuals (mean age: 85.5 ± 3.3 years, 54.0% women), 75 (30.0%) reported a negative impact on mental health, while 175 (70.0%) reported either a positive impact (n = 4) or no impact at all (n = 171). In the binary logistic regression model, factors associated with a decline in mental health included loneliness (odds ratio [95% confidence interval]) (3.87 [1.83-8.17]) and difficulty adhering to social distancing recommendations (5.10 [1.92-13.53]). High morale was associated with positive or no impact on mental health (0.37 [0.17-0.82]). Conclusions: A high percentage of very old people reported a negative impact on mental health from the COVID-19 pandemic, primarily from loneliness and difficulty adhering to social distancing measures, while high morale seemed to be a protective factor.
MeSH term(s)	Humans ; Female ; Aged, 80 and over ; Male ; COVID-19/epidemiology ; Sweden/epidemiology ; Cross-Sectional Studies ; Mental Health ; Pandemics ; Loneliness
Language	English
Publishing date	2024-04-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0299098
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Article: Long-term sequelae following acute pulmonary embolism: A nationwide follow-up study regarding the incidence of CTEPH, dyspnea, echocardiographic and V/Q scan abnormalities.

Andersson, Therese / Nilsson, Lars / Larsen, Flemming / Carlberg, Bo / Söderberg, Stefan

Pulmonary circulation

2023 Volume 13, Issue 4, Page(s) e12306

Abstract: We aimed to follow a nationwide cohort of patients with pulmonary embolism (PE) without any exclusions to generate information regarding long-term symptoms, investigational findings and to determine the prevalence of chronic thromboembolic pulmonary ... ...

Abstract	We aimed to follow a nationwide cohort of patients with pulmonary embolism (PE) without any exclusions to generate information regarding long-term symptoms, investigational findings and to determine the prevalence of chronic thromboembolic pulmonary hypertension (CTEPH). We hypothesized that this approach would yield generalizable estimates of CTEPH prevalence and incidence. All individuals diagnosed with acute PE in Sweden in 2005 were identified using the National Patient Register. In 2007, survivors were asked to complete a questionnaire regarding current symptoms. Those with dyspnea were referred for further examinations with laboratory tests, electrocardiogram (ECG), and a ventilation/perfusion scan (V/Q scan). If CTEPH was suspected, a referral to the nearest pulmonary arterial hypertension-center was recommended. Of 5793 unique individuals with PE diagnosis in 2005, 3510 were alive at the beginning of 2007. Altogether 53% reported dyspnea at some degree whereof a large proportion had V/Q scans indicating mismatched defects. Further investigation revealed 6 cases of CTEPH and in parallel 18 cases were diagnosed outside this study. The overall prevalence of CTEPH was 0.4% (95% confidence interval [CI]: 0.2%-0.6%) and 0.7% (95% CI: 0.4%-1.0%) among the survivors. The cumulative incidence of CTEPH in the group of patients who underwent a V/Q scan was 1.1% (95% CI: 0.2%-2.0%). There was a high mortality following an acute PE, a high proportion of persistent dyspnea among survivors, whereof several had pathological findings on V/Q scans and echocardiography. Only a minority developed CTEPH, indicating that CTEPH is the tip of the iceberg of post-PE disturbances.
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2638089-4
ISSN	2045-8940 ; 2045-8932
ISSN (online)	2045-8940
ISSN	2045-8932
DOI	10.1002/pul2.12306
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Article ; Online: The impact of community-based prevention on quality of life-The necessity to control for general health trends the Northern Sweden MONICA study in 2014.

Spege, Elin / Ek, Kristina / Söderberg, Stefan / Eliasson, Mats

PloS one

2021 Volume 16, Issue 9, Page(s) e0256872

Abstract: Background: The Västerbotten intervention program (VIP), is a public health promotion program in northern Sweden with the aim of preventing cardiovascular disease. Positive effects have been reported although the evidence is not unequivocal. Since only ... ...

Abstract	Background: The Västerbotten intervention program (VIP), is a public health promotion program in northern Sweden with the aim of preventing cardiovascular disease. Positive effects have been reported although the evidence is not unequivocal. Since only historical controls have been used, effects from other sources than the program have largely been uncontrolled for and health related quality of life (HRQoL) has not been evaluated. Purpose: By using the neighbouring county of Norrbotten (NB) as the reference population, we compare HRQoL in Västerbotten (VB) and in NB. Methods: In 2014 the Northern Sweden survey, Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA), examined a random sample from the two counties. HRQoL was measured with the EQ-5D-3L. In total, 1112 subjects aged 40-74 years participated, 516 in VB and 594 in NB. Differences in mean QoL between VB and NB were analysed via Student's t-test and the Pearson chi-square test. Results: Average HRQoL measured by the EQ-5D-index was 0.798 in VB and 0.811 in NB, a difference of 0.013 (p = 0.2, CI -0.009 to 0.036). For subjects aged 45-54 years, the HRQoL was lower in VB than in NB, a difference of 0.048 (p = 0.041; CI 0.002 to 0.0094). Men had higher HRQoL than women, and university educated had higher HRQoL than those without university education. EQ-VAS showed similar results. Subjects from NB and from VB did not differ regarding age, gender and level of education. In NB, HRQoL decrease with age, a pattern not seen in VB. Conclusions: We found similar levels of HRQoL in VB and in NB.
MeSH term(s)	Adult ; Age Factors ; Aged ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Educational Status ; Female ; Humans ; Life Style ; Male ; Middle Aged ; Public Health/trends ; Quality of Life ; Risk Factors ; Sex Factors ; Surveys and Questionnaires ; Sweden/epidemiology
Language	English
Publishing date	2021-09-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0256872
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Article ; Online: Preventive Interventions to Reduce the Burden of Rheumatic Heart Disease in Populations at Risk: A Systematic Review.

Shimanda, Panduleni Penipawa / Shumba, Tonderai W / Brunström, Mattias / Iipinge, Scholastika N / Söderberg, Stefan / Lindholm, Lars / Norström, Fredrik

Journal of the American Heart Association

2024 Volume 13, Issue 5, Page(s) e032442

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 ... ...

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. Methods and 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 Conclusions: This systematic review underscores the importance of various preventive interventions in reducing the incidence and burden of Group A Registration: URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42020170503.
MeSH term(s)	Humans ; Rheumatic Heart Disease/diagnosis ; Rheumatic Heart Disease/epidemiology ; Rheumatic Heart Disease/prevention & control ; Rheumatic Fever/diagnosis ; Rheumatic Fever/epidemiology ; Rheumatic Fever/prevention & control ; Streptococcal Infections/epidemiology ; Streptococcal Infections/prevention & control ; Pharyngitis/epidemiology ; Pharyngitis/prevention & control ; Pharyngitis/complications ; Risk Factors
Language	English
Publishing date	2024-02-23
Publishing country	England
Document type	Systematic Review ; Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.032442
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Article ; Online: Health-related quality of life and healthcare consultations among adult patients before and after diagnosis with rheumatic heart disease in Namibia.

Shimanda, Panduleni Penipawa / Söderberg, Stefan / Iipinge, Scholastika Ndatinda / Lindholm, Lars / Shidhika, Fenny Fiindje / Norström, Fredrik

BMC cardiovascular disorders

2023 Volume 23, Issue 1, Page(s) 456

Abstract: Background: Rheumatic Heart Disease (RHD) causes high morbidity and mortality rates among children and young adults, impacting negatively on their health-related quality of life (HRQoL). This study aimed to evaluate the HRQoL and healthcare ... ...

Abstract	Background: Rheumatic Heart Disease (RHD) causes high morbidity and mortality rates among children and young adults, impacting negatively on their health-related quality of life (HRQoL). This study aimed to evaluate the HRQoL and healthcare consultations of adult patients with RHD in Namibia. Methods: From June 2019 to March 2020, a questionnaire was administered to 83 RHD patients during routine follow-ups. The EQ-5D-5L instrument was used to assess the health-related quality of life before diagnosis and at the time of the survey. The Ethiopian value set for EQ-5D-5L was used to calculate Quality-Adjusted Life Years (QALY). Results: Most respondents were women (77%), young adults below the age of 30 years (42%), and individuals who grew up in rural areas (87%). The mean QALY statistically significantly improved from 0.773 pre-diagnosis to 0.942 in the last 12 months (p < 0.001). Sixty-six patients who had surgery reported a better QALY. Healthcare visits statistically significantly increased from on average 1.6 pre-diagnosis to 2.7 days in the last 12 months (p < 0.001). The mean distance to the nearest facility was 55 km, mean cost of transport was N$65, and mean time spent at the clinic was 3.6 h. The median time from diagnosis to the survey was 7 years (quartiles 4 and 14 years). Conclusion: Treatment and surgery can improve HRQoL substantially among RHD patients. Being diagnosed with RHD affects patients living in socioeconomically disadvantaged rural areas through cost and time for healthcare visits. It would be valuable with further research to understand differences between disease severities.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Ambulatory Care Facilities ; Namibia/epidemiology ; Quality of Life ; Rheumatic Heart Disease/diagnosis ; Rheumatic Heart Disease/epidemiology ; Rheumatic Heart Disease/therapy
Language	English
Publishing date	2023-09-14
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-023-03504-4
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Article ; Online: Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation.

Law, Lucy / Lindqvist, Per / Liv, Per / Hellman, Urban / Lejon, Kristina / Geijer, Mats / Söderberg, Stefan / Forsblad-d'Elia, Helena

Clinical rheumatology

2024 Volume 43, Issue 5, Page(s) 1559–1570

Abstract: Objective: There is an increased risk for cardiovascular disease (CVD) in patients with radiographic axial spondyloarthritis (r-axSpA). In this cross-sectional study, we aimed to, overall and stratified by sex, (i) compare ultrasound derived carotid ... ...

Abstract	Objective: There is an increased risk for cardiovascular disease (CVD) in patients with radiographic axial spondyloarthritis (r-axSpA). In this cross-sectional study, we aimed to, overall and stratified by sex, (i) compare ultrasound derived carotid intima media thickness (cIMT), between patients and controls, and (ii) investigate associations between cIMT, clinical disease activity and inflammation-related laboratory markers in patients with r-axSpA. Method: In total, 155 patients diagnosed with r-axSpA using the modified New York criteria and 400 controls were included. Bilateral carotid ultrasound, laboratory testing, and questionaries were acquired. Disease-specific assessments were carried out for patients. Linear regression analysis was used to assess associations. Results: Linear regression analyses showed that patients with r-axSpA had increased mean cIMT compared to controls (mean ± SD, 0.8 ± 0.1 mm vs 0.7± 0.1 mm, respectively, unstandardized β (95% CI) -0.076 (-0.10, -0.052), P < 0.001) adjusted for smoking status and age. Linear regression analyses for patients with r-axSpA showed that only males presented significant associations between cIMT and inflammation-related laboratory markers, white blood cell (WBC) count (mean ± SD, 6.8 ± 1.6 10 Conclusion: Patients with r-axSpA had significantly increased cIMT compared to controls. In male patients, higher WBC and monocyte count were associated with an increase in cIMT suggesting the role of inflammation in the development of atherosclerosis. Key Points •Carotid intima-media thickness was increased in patients with radiographic axial spondyloarthritis compared to controls. •White blood cell and monocyte counts were associated with carotid intima-media thickness in male patients with radiographic axial spondyloarthritis.
MeSH term(s)	Humans ; Male ; Carotid Intima-Media Thickness ; Cross-Sectional Studies ; Inflammation ; Biomarkers ; Axial Spondyloarthritis ; Risk Factors
Chemical Substances	Biomarkers
Language	English
Publishing date	2024-03-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-024-06913-8
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Zs.A 1740: Show issues

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Article ; Online: Real-World Management of Patients with Pulmonary Arterial Hypertension: Insights from EXPOSURE.

Muller, Audrey / Escribano-Subias, Pilar / Fernandes, Catarina C / Fontana, Martina / Lange, Tobias J / Söderberg, Stefan / Gaine, Sean

Advances in therapy

2024 Volume 41, Issue 3, Page(s) 1103–1119

Abstract: Introduction: Further insights into real-world management and outcomes of patients with pulmonary arterial hypertension (PAH) are needed. This interim analysis of the ongoing, multicentre, prospective EXPOSURE (EUPAS19085) observational study describes ... ...

Abstract	Introduction: Further insights into real-world management and outcomes of patients with pulmonary arterial hypertension (PAH) are needed. This interim analysis of the ongoing, multicentre, prospective EXPOSURE (EUPAS19085) observational study describes characteristics, treatment patterns and outcomes of patients with PAH initiating a new PAH-specific therapy in Europe/Canada. Methods and results: All analyses were descriptive. In total, 1944 patients with follow-up information were included; the majority were female, with World Health Organization functional class II/III symptoms and with idiopathic PAH or connective tissue disease-associated PAH. Most incident patients (N = 1100; diagnosed for ≤ 6 months) initiated treatment as monotherapy (48%) or double therapy (43%). Of those initiating monotherapy, 38% (199/530) escalated to double therapy (median [Q1, Q3] time to escalation 3.4 [1.9, 6.6] months), and of those initiating double therapy, 17% (78/457) escalated to triple therapy (median [Q1, Q3] time to escalation 7.0 [3.4, 12.7] months) during the observation period (median [Q1, Q3]: 17.0 [7.5, 29.9] months). The majority of the 834 prevalent patients (diagnosed > 6 months) entered the study on initiation of combination therapy and most did not change treatment regimen during the observation period (median [Q1, Q3]: 19.6 [10.2, 32.2] months). One-year survival was 88% for incident patients and 90% for prevalent patients. Conclusions: Results from EXPOSURE suggest a shift towards combination therapy and the alignment of real-world treatment patterns with current guideline recommendations. While survival estimates are encouraging, the extent of monotherapy use at treatment initiation and follow-up highlight an opportunity for further improvements through optimisation of treatment strategies in line with current guidelines. A graphical abstract is also available with this article. Trial registration number: EUPAS19085.
MeSH term(s)	Humans ; Male ; Female ; Pulmonary Arterial Hypertension/drug therapy ; Hypertension, Pulmonary/drug therapy ; Hypertension, Pulmonary/diagnosis ; Prospective Studies ; Retrospective Studies ; Familial Primary Pulmonary Hypertension
Language	English
Publishing date	2024-01-13
Publishing country	United States
Document type	Observational Study ; Multicenter Study ; Journal Article
ZDB-ID	632651-1
ISSN	1865-8652 ; 0741-238X
ISSN (online)	1865-8652
ISSN	0741-238X
DOI	10.1007/s12325-023-02730-8
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Zs.A 2101: Show issues

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Article ; Online: Association between snus use and lipid status in Swedish men.

Byhamre, Marja Lisa / Eliasson, Mats / Söderberg, Stefan / Wennberg, Patrik / Oskarsson, Viktor

Scandinavian journal of clinical and laboratory investigation

2023 Volume 83, Issue 4, Page(s) 241–250

Abstract: Snus is a common tobacco product in Sweden, but the cardiovascular risk profile for snus users is less known than for cigarette smokers. We examined the association of snus use with lipid status, particularly in comparison to non-tobacco use and ... ...

Abstract	Snus is a common tobacco product in Sweden, but the cardiovascular risk profile for snus users is less known than for cigarette smokers. We examined the association of snus use with lipid status, particularly in comparison to non-tobacco use and cigarette smoking, using data from 5930 men in the Northern Sweden MONICA study. Tobacco use was self-reported in 1986 to 2014 (24.4% used snus) and blood samples were collected at the same time. Harmonized analyses on non-high-density lipoprotein (non-HDL) cholesterol, HDL cholesterol, and triglycerides were conducted in 2016 to 2018. Three hundred eighty-one snus users had also been examined more than once, allowing us to study the effect of discontinued use (achieved by 21.0%). In multivariable linear regression models, snus use was associated with higher HDL cholesterol and triglyceride concentrations compared to non-tobacco use (
MeSH term(s)	Male ; Humans ; Tobacco, Smokeless/adverse effects ; Sweden/epidemiology ; Cholesterol ; Cholesterol, HDL ; Triglycerides
Chemical Substances	Cholesterol (97C5T2UQ7J) ; Cholesterol, HDL ; Triglycerides
Language	English
Publishing date	2023-05-11
Publishing country	England
Document type	Journal Article
ZDB-ID	3150-1
ISSN	1502-7686 ; 0036-5513
ISSN (online)	1502-7686
ISSN	0036-5513
DOI	10.1080/00365513.2023.2209915
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Article ; Online: Fasting C-peptide at type 2 diabetes diagnosis is an independent risk factor for total and cancer mortality.

Otten, Julia / Tavelin, Björn / Söderberg, Stefan / Rolandsson, Olov

Diabetes/metabolism research and reviews

2021 Volume 38, Issue 3, Page(s) e3512

Abstract: Aims: We assessed the association between insulin resistance and blood glucose concentrations at type 2 diabetes diagnosis and future development of diabetes-related complications and mortality.: Materials and methods: This retrospective cohort study ...

Abstract	Aims: We assessed the association between insulin resistance and blood glucose concentrations at type 2 diabetes diagnosis and future development of diabetes-related complications and mortality. Materials and methods: This retrospective cohort study included 864 individuals with type 2 diabetes (median age 60 years) whose fasting C-peptide and HbA1c were measured at diabetes diagnosis. The median follow-up time until death or study end was 16.4 years (interquartile range 13.3-19.6). The association between C-peptide and mortality/complications was estimated by Cox regression adjusted for sex, age at diabetes diagnosis, smoking, hypertension, BMI, total cholesterol, and HbA1c. C-peptide and HbA1c were converted to Z scores before the Cox regression analysis. Results: An increase by one standard deviation in fasting C-peptide at diabetes diagnosis was associated with all-cause (hazard ratio [HR] 1.33; 95% confidence intervals [CI] 1.12-1.58; p = 0.001) and cancer mortality (HR 1.51; 95% CI 1.13-2.01; p = 0.005) in the fully adjusted model. An increase by one standard deviation in HbA1c at diabetes diagnosis was associated with all-cause mortality (HR 1.24; 95% CI 1.07-1.44; p = 0.005), major cardiovascular events (HR 1.20; 95% CI 1.04-1.39; p = 0.015), stroke (HR 1.36; 95% CI 1.09-1.70; p = 0.006), and retinopathy (HR 1.54; 95% CI 1.34-1.76; p < 0.0001) in the fully adjusted model. Conclusions: Fasting C-peptide at type 2 diabetes diagnosis is an independent risk factor for total and cancer-related mortality. Thus, treatment of type 2 diabetes should focus not only on normalising blood glucose levels but also on mitigating insulin resistance.
MeSH term(s)	Blood Glucose/analysis ; C-Peptide ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diagnosis ; Fasting ; Glycated Hemoglobin A/analysis ; Humans ; Middle Aged ; Neoplasms/diagnosis ; Retrospective Studies ; Risk Factors
Chemical Substances	Blood Glucose ; C-Peptide ; Glycated Hemoglobin A
Language	English
Publishing date	2021-11-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1470192-3
ISSN	1520-7560 ; 1520-7552
ISSN (online)	1520-7560
ISSN	1520-7552
DOI	10.1002/dmrr.3512
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Zs.A 2119: Show issues

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Article ; Online: Rheumatic heart disease prevalence in Namibia: a retrospective review of surveillance registers.

Shimanda, Panduleni Penipawa / Söderberg, Stefan / Iipinge, Scholastika Ndatinda / Neliwa, Ebba Mwalundouta / Shidhika, Fenny Fiindje / Norström, Fredrik

BMC cardiovascular disorders

2022 Volume 22, Issue 1, Page(s) 266

Abstract: Background: Rheumatic heart disease (RHD) is the most commonly acquired heart disease in children and young people in low and middle-income settings. Fragile health systems and scarcity of data persist to limit the understanding of the relative burden ... ...

Abstract	Background: Rheumatic heart disease (RHD) is the most commonly acquired heart disease in children and young people in low and middle-income settings. Fragile health systems and scarcity of data persist to limit the understanding of the relative burden of this disease. The aims of this study were to estimate the prevalence of RHD and to assess the RHD-related health care systems in Namibia. Methods: Data was retrieved from outpatient and inpatient registers for all patients diagnosed and treated for RHD between January 2010 to December 2020. We used descriptive statistics to estimate the prevalence of RHD. Key observations and engagement with local cardiac clinicians and patients helped to identify key areas of improvement in the systems. Results: The outpatient register covered 0.032% of the adult Namibian population and combined with the cumulative incidence from the inpatient register we predict the prevalence of clinically diagnosed RHD to be between 0.05% and 0.10% in Namibia. Young people (< 18 years old) are most affected (72%), and most cases are from the north-eastern regions. Mitral heart valve impairment (58%) was the most common among patients. We identified weaknesses in care systems i.e., lack of patient unique identifiers, missing data, and clinic-based prevention activities. Conclusion: The prevalence of RHD is expected to be lower than previously reported. It will be valuable to investigate latent RHD and patient follow-ups for better estimates of the true burden of disease. Surveillance systems needs improvements to enhance data quality. Plans for expansions of the clinic-based interventions must adopt the "Awareness Surveillance Advocacy Prevention" framework supported by relevant resolutions by the WHO.
MeSH term(s)	Adolescent ; Adult ; Child ; Humans ; Namibia/epidemiology ; Prevalence ; Retrospective Studies ; Rheumatic Fever/epidemiology ; Rheumatic Heart Disease/diagnosis ; Rheumatic Heart Disease/epidemiology ; Rheumatic Heart Disease/therapy
Language	English
Publishing date	2022-06-14
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-022-02699-2
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