ArticlePLoS neglected tropical diseases2025
The burden of rheumatic heart disease and issues affecting the provision of care in Malawi: A scoping review.
Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Can transesophageal echocardiography be safely deferred? A low-cost predictive model using D-dimer to exclude left atrial thrombus in treatment-naïve rheumatic mitral stenosis.Frontiers in cardiovascular medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRheumatic heart disease (RHD) is an autoimmune sequela of group A streptococcal (GAS) pharyngitis. Acute rheumatic fever (ARF), a complication arising 2-3 weeks after GAS infection, can cause damage to the valves of the heart and, ultimately, RHD. This trajectory towards severe disease is now rare in high-income countries. In Malawi, as in many low-income countries, RHD continues to pose a significant challenge. Limited access to healthcare and poor education likely contribute to the disease burden. This scoping review aims to determine the present burden of GAS, ARF and RHD in Malawi, the issues affecting the provision of care and the solutions that have been proposed.
methodA search was conducted of 'PubMed', 'EMBASE', 'Cochrane Library' and 'Clinicaltrials.gov' to identify research published between 1995 and 2024 according to the Arksey and O'Malley framework. The PRISMA extension for Scoping Review (PRISMA-ScR) Checklist guided the search (Supplementary File 3).
resultsData were extracted from thirty articles. RHD prevalence among Malawian children ranges between 3.4% and 5.3%, with high rates of late presentation (62%-82.5% presenting with severe disease). Inadequate health system infrastructure, limited RHD-specific education for healthcare providers, and inconsistent availability of benzathine penicillin G for secondary prophylaxis were identified as key challenges. Rural areas, comprising 84% of Malawi's population, are particularly underserved. Task-shifting to non-physician healthcare workers in primary care has shown promise. Much less research was available on ARF and GAS infections.
conclusionThe significant morbidity and mortality associated with RHD is a major concern in the communities and healthcare systems of Malawi. Primary care resourcing and improved education are areas requiring attention. To address the high burden of disease in the country, ongoing research is largely focused on establishing a sufficiently large and appropriately trained workforce to diagnose and monitor RHD using the resources available within the constraints of the country's socioeconomic context.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.