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Rheumatic Heart Disease and Screening (RHD)

Rheumatic Heart Disease and Screening: A Feasibility Study, a collaborative research study project of University of Washington, Dhulikhel Hospital, Manmohan Cardiothoracic Vascular and Transplant Center, Shahid Gangalal National Heart Center and Nobel Medical Hospital Pvt. Ltd is being conducted through Department of Research and Development, Dhulikhel Hospital- Kathmandu University Hospital since 2018 AD. Funded by Department of Health and Human Services, National Institutes of Health, this study is both qualitative and quantitative study. It aims to:

  • establish an RHD registry and determine the feasibility of echocardiographic screening of first degree relatives of rheumatic heart disease (RHD) patients in Nepal.
  • determine the opportunities and challenges of incorporating this novel screening approach into a national RHD program in Nepal through semi-structure interviews with key stakeholders, policymakers, and healthcare providers.

This study had ran a nurse led echocardiography screening workshop through which the nurses got the chance to learn and perform echocardiography screening. Various further ongoing activities includes hospital based patient registry, electronic registry and qualitative data collections. With an aim to efficiently examine BPP adherence and its predictors, the electronic registry was developed. Additionally, the registry will be also used as a platform for recruiting participants with RHD to screen their first-degree relatives for RHD. First-degree relatives share common genetic and environmental risk factors, and so screening the first-degree relatives of patients with known RHD for RHD as, it would be a high-yield method of detecting cases and connecting them to care. Findings from this and future larger studies examining these questions will yield insights that will potentially transform the global RHD landscape.

Nurse led Echocardiography Screening Workshop

If implemented, this study project would be valuable for four reasons. First, this will be a high-yield screening approach for RHD in Nepal. Second, this screening would be relatively easy to implement by properly counseling patients with a patient-centered and culture-centered approach and inviting the first-degree relatives for a screening visit. Third, this will provide an unparalleled opportunity for educating this high-risk group on the prevention of RHD by promptly treating future throat infections. Fourth, this will provide a unique opportunity to study the epidemiology of RHD in adults, which remains poorly understood.

Hospital Based Patient Registry

With an aim to determine the role of Statins in slowing Rheumatic Heart Disease (RHD) progression, to examine the enrollment, adherence, and retention rates for statin and to examine the feasibility of larger Randomized Controlled Trial (RCT) from outcomes of the current RCT, Dhulikhel Hospital in collaboration with University of Washington has been conducting a clinical trial entitled, “Role of Statins in Slowing Rheumatic Heart Disease(RHD) Progression: A Feasibility Study for a Randomized Controlled Trial” at Manmohan Cardiothoracic Vascular and Transplant Center(MCVTC), Maharajgunj, Kathmandu, Nepal. The funding organization for this study project is Department of Health and Human Services, National Institutes of Health.

Currently, this study is in the participant enrollment and study pills distribution phase. The participant are selected carefully following the study criteria and protocol and are exclusively from various parts of Nepal. The core team members are determined to achieve the study goals timely with full dedications. This study had also provided echocardiography training to the cardiologists at the beginning of the participant enrollment.

Activities