MORE THAN 1000 children in the age group of 5-15 who have been identified with rheumatic heart disease and other heart complications are being treated free of charge with penicillin injections as part of the Indian Council of Medical Research’s (ICMR) RF/RHD Project under the Jai Vigyan Mission Mode Project on Community Control being run here at MY Hospital.
This assumes significance in view of the fact that even when rheumatic fever and related rheumatic heart diseases have disappeared from the western countries, India and several other developing countries continue to wage war against complications caused due to streptococcal sore throat.
The project continues to sensitise masses about prevention and cure through public awareness and education. Through surveys and ‘health melas’ the project has been mapping RF and RHD patients, particularly those between 5-15 years of age across 43 municipal wards from legislature zones 2, 3 and 4 in the City.
“We have screened more than 25,000 children till date. Children identified with the problem are asked to register after which a cardiac evaluation is carried out (echo test is also done). Those detected with the disease, are given penicillin injections every three weeks free of cost,” Principal Investigator of the project Dr Anil Bharani told Hindustan Times.
Rahul Maheshwari, a research assistant with the project says, “A total of 25,676 children in the age group of 5-15 years have been screened of whom almost 50 per cent are from the municipal schools.”
There is a main area registry (as part of the ICMR project) and another is MY Registry for all those who do not fall in the pre-decided area of the project. “Till December 20, a total of 1066 cases have been registered of which 594 are area registry cases.”
A team of about eight persons has conducted more than 100 health melas during the last two years. “The most interesting part of these melas is an exhibition ‘Mini ki Kahani’, which depicts how a child can acquire RF/RHD infection. A questionnaire is given to all those attending the event and winners are also given token prizes,” Maheshwari adds.
ICMR has been carrying out these projects to study the prevalence of the disease to develop a vaccine. After repeated attacks of RF, some patients may develop permanent scarring and damage of heart valves.
With costly cardiac surgeries being out of reach of most of the people, the only hope to overcome the disease is an RF vaccine.
Although this infection can be contracted by any child, family’s socio-economic status plays an important role. Probably, that explains why developed countries have been able to ward off the menace while the developing countries ridden with poverty, excess population and most importantly lack of access to medical care are still facing the scourge.
The research body has undertaken vaccine development through Indian strains. With the samples collected at Indore registry and at other three registries, research is being done at CMC Vellore and PGI Chandigarh for the M-protein based vaccine.
“However, there are practical difficulties. For example, the strains found in south India and at Indore are different.
Also, the group A streptococcus bacteria can deceive M protein and hence an attempt is being made to develop vaccine with other targets,” according to Dr Bharani.
But given the efforts put in, the vaccine cannot be ruled out as a possibility in the near future. And till the time we have a vaccine, which takes care of the local strain, the only option is the timely diagnosis and treatment with penicillin at the registry, functional since December 2004.