{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:13:43Z","timestamp":1792271623606,"version":"4.4.0"},"reference-count":228,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Nearly a century after rheumatic fever (RF) and rheumatic heart disease (RHD) was eradicated from the developed world, the disease remains endemic in many low- and middle-income countries (LMICs), with grim health and socioeconomic impacts. The neglect of RHD which persisted for a semi-centennial was further driven by competing infectious diseases, particularly the human immunodeficiency virus (HIV) pandemic. However, over the last two-decades, slowly at first but with building momentum, there has been a resurgence of interest in RF\/RHD. In this narrative review, we present the advances that have been made in the RF\/RHD continuum over the past two decades since the re-awakening of interest, with a more concise focus on the last decade\u2019s achievements. Such primary advances include understanding the genetic predisposition to RHD, group A Streptococcus (GAS) vaccine development, and improved diagnostic strategies for GAS pharyngitis. Echocardiographic screening for RHD has been a major advance which has unearthed the prevailing high burden of RHD and the recent demonstration of benefit of secondary antibiotic prophylaxis on halting progression of latent RHD is a major step forward. Multiple befitting advances in tertiary management of RHD have also been realized. Finally, we summarize the research gaps and provide illumination on profitable future directions towards global eradication of RHD.<\/jats:p>","DOI":"10.3390\/pathogens11020179","type":"journal-article","created":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T05:26:17Z","timestamp":1643433977000},"page":"179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Recent Advances in the Rheumatic Fever and Rheumatic Heart Disease Continuum"],"prefix":"10.3390","volume":"11","author":[{"given":"Joselyn","family":"Rwebembera","sequence":"first","affiliation":[{"name":"Department of Adult Cardiology (JR), Uganda Heart Institute, Kampala 37392, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno Ramos","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Departamento de Clinica Medica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil"},{"name":"Servico de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaude, Hospital das Clinicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110, 1st Floor, Belo Horizonte 30130-100, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neema W.","family":"Minja","sequence":"additional","affiliation":[{"name":"Rheumatic Heart Disease Research Collaborative in Uganda, Uganda Heart Institute, Kampala 37392, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"de Loizaga","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Twalib","family":"Aliku","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology (TA), Uganda Heart Institute, Kampala 37392, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiza Pereira Afonso","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Departamento de Clinica Medica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1380-7589","authenticated-orcid":false,"given":"Bruno Fernandes","family":"Galdino","sequence":"additional","affiliation":[{"name":"Departamento de Clinica Medica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiza Silame","family":"Corte","sequence":"additional","affiliation":[{"name":"Departamento de Clinica Medica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente Rezende","family":"Silva","sequence":"additional","affiliation":[{"name":"Departamento de Clinica Medica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3009-6678","authenticated-orcid":false,"given":"Andrew Young","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walderez Ornelas","family":"Dutra","sequence":"additional","affiliation":[{"name":"Laboratory of Cell-Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 30130-100, MG, Brazil"},{"name":"National Institute of Science and Technology in Tropical Diseases (INCT-DT), Salvador 40170-970, BA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Carmo Pereira","family":"Nunes","sequence":"additional","affiliation":[{"name":"Departamento de Clinica Medica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil"},{"name":"Servico de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaude, Hospital das Clinicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110, 1st Floor, Belo Horizonte 30130-100, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Zawacki","family":"Beaton","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA"},{"name":"Cincinnati Children\u2019s Hospital Medical Center, The Heart Institute, Cincinnati, OH 45229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"ref_1","unstructured":"Ferretti, J., and K\u00f6hler, W. 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