{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:26:10Z","timestamp":1793755570573,"version":"4.6.1"},"reference-count":63,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,3,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Rheumatic heart disease (RHD) is a devastating yet preventable condition that disproportionately affects low\u2010middle\u2013income countries and indigenous populations in some high\u2010income 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              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\u2010based primary prevention services targeting the early detection and treatment of Group A\n              <jats:italic>Streptococcus<\/jats:italic>\n              pharyngitis infection with penicillin have the potential to reduce the incidence of Group A\n              <jats:italic>Streptococcus<\/jats:italic>\n              pharyngitis and acute rheumatic fever. Community\u2010based programs using various prevention strategies also reduced the burden of RHD. However, there is limited evidence from low\u2010middle\u2013income countries and a lack of rigorous evaluations reporting the true impact of the interventions. Narrative synthesis was performed, and the methodological quality appraisal was done using the Joanna Briggs Institute critical appraisal tools.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This systematic review underscores the importance of various preventive interventions in reducing the incidence and burden of Group A\n              <jats:italic>Streptococcus<\/jats:italic>\n              pharyngitis, acute rheumatic fever, and RHD. Rigorous evaluations and comprehensive analyses of interventions are necessary for guiding effective strategies and informing public health policies to prevent and reduce the burden of these diseases in diverse populations.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/\">https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n              ; Unique identifier: CRD42020170503.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.032442","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T10:50:52Z","timestamp":1708685452000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Preventive Interventions to Reduce the Burden of Rheumatic Heart Disease in Populations at Risk: A Systematic Review"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0899-2185","authenticated-orcid":false,"given":"Panduleni Penipawa","family":"Shimanda","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Global Health Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-1043","authenticated-orcid":false,"given":"Tonderai W.","family":"Shumba","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy and Physiotherapy University of Namibia Windhoek Namibia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7054-0905","authenticated-orcid":false,"given":"Mattias","family":"Brunstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Cardiology Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9785-6467","authenticated-orcid":false,"given":"Scholastika N.","family":"Iipinge","sequence":"additional","affiliation":[{"name":"Clara Barton School of Nursing, Welwitchia Health Training Centre Windhoek Namibia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9225-1306","authenticated-orcid":false,"given":"Stefan","family":"S\u00f6derberg","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Cardiology Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1633-2179","authenticated-orcid":false,"given":"Lars","family":"Lindholm","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Global Health Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0457-2175","authenticated-orcid":false,"given":"Fredrik","family":"Norstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Global Health Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025284"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30999-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2013.08.005"},{"key":"e_1_3_2_5_2","first-page":"212","article-title":"Intramuscular penicillin is more effective than oral penicillin in secondary prevention of rheumatic fever\u2010a systematic review","volume":"93","author":"Manyemba J","year":"2003","unstructured":"Manyemba J, Mayosi BM. 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