{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:05:31Z","timestamp":1790021131074,"version":"4.0.1"},"reference-count":284,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Rheumatic heart disease (RHD) continues to be a significant global health burden, particularly in resource-limited regions of the world. This preventable and often neglected disease affects predominantly children and young adults, leading to considerable morbidity and mortality. In this article, we revisit the Cairo Accord that aims to address the challenges of RHD and set policy priorities for its eradication. We highlight the most remarkable progress in the field since the 2021 update, formulating updated recommendations. These include enhancing disease registries and echocardiographic screening, advance research on host and streptococcal strains genetics, biomarkers, vaccines, pharmaceuticals and penicillin prophylaxis, accelerate the development of regional Centers of Excellence, promoting MV repair and the development of tissue-engineered valve substitutes.<\/jats:p>","DOI":"10.3389\/fcvm.2026.1799972","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:54:46Z","timestamp":1778219686000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The \u201cCairo Accord\u201d- towards the eradication of RHD: revisited (2026)"],"prefix":"10.3389","volume":"13","author":[{"given":"Susy","family":"Kotit","sequence":"first","affiliation":[{"name":"Aswan Heart Centre, Magdi Yacoub Heart Foundation","place":["Aswan, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdi","family":"Yacoub","sequence":"additional","affiliation":[{"name":"Aswan Heart Centre, Magdi Yacoub Heart Foundation","place":["Aswan, Egypt"]},{"name":"Heart Science Centre, National Heart and Lung Institute, Imperial College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.1016\/j.jacc.2018.06.063","article-title":"Rheumatic heart disease worldwide: JACC scientific expert panel","volume":"72","author":"Watkins","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1056\/NEJMoa1603693","article-title":"Global, regional, and national burden of rheumatic heart disease, 1990\u20132015","volume":"377","author":"Watkins","year":"2017","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.3928\/19382359-20210221-01","article-title":"Rheumatic fever and rheumatic heart disease in the United States","volume":"50","author":"de Loizaga","year":"2021","journal-title":"Pediatr Ann"},{"key":"B4","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/S2352-4642(20)30308-4","article-title":"Rheumatic heart disease in indigenous young peoples","volume":"5","author":"Wyber","year":"2021","journal-title":"Lancet Child Adolesc Heal"},{"key":"B5","doi-asserted-by":"publisher","first-page":"131705","DOI":"10.1016\/j.ijcard.2023.131705","article-title":"Epidemiological study of pediatric rheumatic heart disease: an analysis from the global burden of disease study 2019","volume":"400","author":"Mao","year":"2024","journal-title":"Int J Cardiol"},{"key":"B6","author":"Zhang","year":"2025"},{"key":"B7","author":"Id","year":"2021"},{"key":"B8","author":"Chen","year":"2025"},{"key":"B9","article-title":"Cardiovascular adverse events in pregnancy: a global perspective","volume":"2021","author":"Kotit","year":"2021","journal-title":"Glob Cardiol Sci Pract"},{"key":"B10","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1126\/science.324.5923.37b","article-title":"Rheumatic fever: neglected again","volume":"324","author":"Watkins","year":"2009","journal-title":"Science"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990\u20132019: update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"B12","author":"Katzenellenbogen","year":"2020"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e0006577","DOI":"10.1371\/journal.pntd.0006577","article-title":"The role of social determinants of health in the risk and prevention of group A streptococcal infection, acute rheumatic fever and rheumatic heart disease: a systematic review","volume":"12","author":"Coffey","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"59","DOI":"10.5339\/gcsp.2014.59","article-title":"Is susceptibility to chronic rheumatic heart disease determined in early infancy? 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