Medical Status in Ethiopia
Ethiopia has one of the world's worst health care systems and despite efforts to improve it, it remains inadequate. The average life expectancy is only 43 years. Only 6% of deliveries are done with trained professionals (doctor, nurse or midwife), compared to a 42% average across Sub-Saharan Africa. The infant mortality remains high at 77 per 1000 live births.
Rheumatic Fever & Rheumatic Heart Valve Disease
Rheumatic heart valve disease (RHVD) arises when there are repeated bouts of rheumatic fever that usually go untreated. Rheumatic fever (RF) in turn arises when there are repeated bouts of strep throat that usually go untreated. These 3 entities are briefly reviewed.
What we've learned
The rheumatic heart valve disease (RHVD) seen in Sub-Saharan Africa is very different from what we are used to. In North America, Europe and a lot of Asia, RHVD has been successfully avoided by treating early episodes of strep throat. This delays or prevents the onset of any rheumatic impact on heart valves. In North America and Europe, we do not see significant valve destruction until the sixth or seventh decades of life. Furthermore, we see very few cases now over the last 20-25 years that reach the point of needing valve surgery. The differences in Sub-Saharan Africa will be outlined in this article.