Tuesday, January 27, 2009


The 18th Dec 2008 issue of Circulation carried an article by Dr Jonathan Carapetis, on new information about an old problem. He highlighted the problem of Rheumatic Heart Disease in Asia. I use to see a lot of Rheumatic Heart disease when I was serving at the University Hospital back in the early 80's. We even had a full specialist cardiac clinic for it. The Chronic Rheumatic Heart Disease clinic. When I left for private practice, I hardly saw any. I took it that chronic rheumatic heart disease was a problem of living in over-crowded conditions with poor sanitation, usually in the lower social economic groups. Therefore, many of them ended up in the public hospitals. I suppose that is largely true. I attend and organise many postgraduate seminars and still I do not see many rheumatic heart disease cases presented.
Well, Dr Carapetis highlighted that many countries in Asia do not have adequate data, even with WHO, on the incidence of Rheumatic Heart Disease. Available statistics come from India, Bangladesh, Pakistan, Philippines, China, Taiwan, Iran, Cambodia, and Saudi Arabia. Of course there are data from Australia and New Zealand. Malaysia is significantly missing from this list. Even Cambodia and Bangladesh, have statistics on this disease. All the reports from these countries, seem to suggest that Rheumatic Heart Disease is these countries is still a formidable problem and we need to be constantly aware to diagnose and this problem. Even more important is the fact that these rheumatic heart disease can be prevented, and therefore lives saved. Unless we have meaniful statistics, we cannot have a meaningful preventive program.
That is what I mean. Cardiac centers of excellence must lead the way, to highlight important cardiac issues to us, so that the country can work towards a good preventive program and thus save lives. Not just trying to outdo private centers in how many angioplasties they have done.
Gong Xi Fa Cai.

1 comment:

amar nawkar said...

respected authour,
it is very true that a valid nd reliable data will be the key for evidence based healthcare planning. i agree with the deficiency in data maintainance, however i guess WHO STEPS aproach towards mantaining NCDdataBase i.e. non communicable disease database can healp to bridge the gap. it helps developing nation to keep a track of NCD acording to the respective country need. a little effort & advocacy for this disease of poor and we can expect positive change.