Prestigious Oration on Rheumatic Heart Disease delivered by Prof Rajesh Kumar during the Award Ceremony

International Academy of Cardiovascular Sciences presented Dr. H.S. Buttar Oration Award to Dr. Rajesh Kumar, Professor of Community Medicine, Head of the School of Public Health, and Dean (Academic), PGIMER.            Prof Rajesh Kumar delivered a talk on "Rheumatic Heart Disease (RHD): A Neglected Public Health Priority".

 Rheumatic Heart Disease (RHD): A Neglected Pubic Health Priority

Dr. Rajesh Kumar, Professor of Community Medicine, Head of the School of Public Health, and Dean (Academic), Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.            email: mobile +919876017948

Although World Health Organisation (WHO) had formulated guidelines for prevention and control of Rheumatic Health Disease (RHD) in 1954 but RHD still continues to be a significant cause of preventable Cardio-Vascular Disease (CVD) morbidity and mortality. It mainly affects children (5-14 years) and young adults (15-24 years), and it is also an important cause of maternal deaths.  

According to the global burden of disease (GBD) 2015 estimates, globally RHD caused 3,19,400 deaths and 3,31,94,900  cases. About 25.5% of left heart failures and 5.3% of right heart failures are considered to be due to RHD. Thus, estimates show that there are about 12,02,000 cases of heart failure due to RHD. Thus, RHD causes loss of 1,05,13,200 disability adjusted life years (DALYs).

RHD burden is primarily (about 80%) located in Low- and Middle-Income Countries (LMICs) of Asia & Africa, where, besides the pre-mature loss of life, it also imposes huge economic burden on families, due to relatively high treatment costs. Contrary to the popular belief, recently GBD study observed that in the last 25 years there is hardly any decline of RHD in LMICs. In High Income Countries (HIGs) RHD has been controlled to a large extent but it still is a significant burden among aboriginal populations in these countries.

In India, RHD is an endemic disease; about 1,31,70,000 cases of RHD were estimated in year 2015, and about 1,19,100 deaths occur every year due to RHD. Despite this high morbidity and mortality load and availability of evidence-based effective prevention and control strategies, which can be implemented even in weak health systems at low cost, RHD has not attracted enough attention of policy makers, program planners, academicians and researchers in India.

India Council of Medical Research had demonstrated that RHD prevention and control program can be successfully implemented within the existing health system. Ministry of Health & Family Welfare Government of India has included RHD in Rashtriya Bal Swasthya Karyakaram (RSBK) as one of the four diseases to be screened among school children, but it is yet to establish RHD registries to organize follow-up for diagnosis, treatment, and prevention on national scale; though it has also recently started pilot program in few districts.

Concerted efforts by Cardiologists, Paediatricians, Community Physicians, Microbiologists, Bio-Medical Scientists and Public Health Advocates are required to attract the attention of policy makers towards RHD. Recent developments in echocardiography, immunology and vaccinology, and a call by WHO to reduce CVD mortality, which includes RHD, by 25% by 2025 have increased the focus on RHD. However, several complex issues need to be resolved to break-through the barriers which impede RHD prevention and control efforts.   

Despite the fact that epidemiological association of Group A Streptococcal (GAS) throat infections were established in the middle of the last century, exact pathogenic mechanisms that link GAS exposure to RHD are not well understood, which has hampered GAS vaccine development efforts. Lack of a robust point-of-care diagnostic test and an effective non-invasive short course treatment of GAS infection has held-back community health workers from the treatment of GAS sore throat, which is a common childhood infection. On an average one GAS sore throat occurs per child per year in 5-15 year age group. Healthcare providers do not like to prescribe painful injections of benzathine penicillin due to the fear of anaphylactic reactions.

Though developments in echocardiography has made RHD screening and diagnosis more accurate. But it is still not clear whether mild cases of RHD picked-up in echocardiographic examination require long-term prophylaxis with injection benzathine penicillin. Cost-effectiveness studies of various RHD prevention and control strategies are also required to place this issue on policy agenda at national and international level as has been done for many neglected tropical diseases.


 Special Regular NSS camp organized at NINE, PGIMER

 Special Seven days Regular (Day & Night) NSS camp was organized by NSS unit of National Institute of Nursing Education, PGIMER at village  Sarangpur (UT),  under the guidance of Dr. Sandhya Ghai, Principal, NINE. During these seven days 145 NSS volunteers participated with great zeal and enthusiasm in various activities at village Sarangpur and in the premises of NINE, PGI, under the supervision of Mrs. Meenakshi Agnihotri and Mrs. Shabana Perveen, Programmer Officers, NSS Unit, NINE, PGI, Chandigarh. All the volunteers of NSS were trained for self defense by Mr. Sanjay, Constable from Chandigarh Police Deptt. Other activities conducted by volunteers include reproductive health campaign, public awareness campaign for prevention and control of HIV/AIDS, Sawachata  Abhiyan at village Sarangpur and at NINE, PGI, Chandigarh, Health Mela to sensitize public regarding various communicable and non communicable diseases. Demonstrations on First Aid techniques were given to villagers & they were advised to have first Aid kit at home.  Awareness for ‘No Honking’ & Road Safety rules including wearing helmet was organized on 6th February 2018 with the assistance of Advocate Rajiv Sharma,  Traffic Marshal, Inspector Sita Devi, & DSP Rajiv Abastha who was the Guest of Honour at the event. Meditation for stress free living was conducted by Brahmkumari for three days.


The camp concluded  with a cultural program organized by NSS volunteers. The function was graced by Chief Guest Sh. J. P. Singh, Regional Director NSS and Sh. Bikram Rana, State Liaison Officer NSS.  Sh. J. P. Singh encouraged the volunteers to participate in NSS activities and to be more associated with the community in which they live. He stressed that a small help can bring big change in the society and can be beneficial for less privileged in the community. Dr. (Mrs.) Sandhya Ghai, Principal, NINE, PGIMER motivated volunteers to use their professional knowledge and skills to serve community.  Student of B.Sc. (Nursing) 1st Year, Ms Navinaaz Kaur recited (self composed) poem about prevention of female foeticide.  A role play was also staged by students on the theme “Beti Bachao Beti Padhao” for women empowerment.  Guest of honour Sh. Bikram Rana enlightened volunteers regarding personality development & gave tips on various aspects of personality development such as decision making, creativity, communication, adjustment & compromise.



 Jeevan Shakti awards will be presented to survivors who have faced the disease bravely and are leading a meaningful life during the joint celebration of CANCER SURVIVORS DAY & International Childhood Cancer Day by SAHAYTA on 10th February at 4:30 p.m. in the auditorium of Government College for Women, Sec 42, Chandigarh. Prof A K Grover, Vice Chancellor, PU, will preside over the function and doctors from PGI and GMCH Sector 32 will grace the occasion.

 Musical Medley by young survivors and a play “Kuch to Log Kahenge” enacted  by our survivors and volunteers under the able guidance of Dr. Chandrashekhar will be the highlight of the celebrations.