ECHO Africa
The Echo in Africa (EIA) project is a collaborative humanitarian effort between the British Society of Echocardiography (BSE) and SUNHEART, a non-profit organisation, located in the Cardiology Division of Stellenbosch University (US) and Tygerberg Hospital (TBH), Cape Town, South Africa. The project offers echo screening for secondary schools in underserved communities in the Western Cape (WC), burdened by dire poverty. RHD is prevalent in these communities where children have poor access to healthcare. Yet, EIA is the only active screening program in the country, limiting the opportunity for early detection and treatment of RHD. Since inception, the project has been facilitated by over 150 accredited volunteer sonographers from around the world. EIA envisages the establishment of a sustained screening program in underserved communities in the WC and the development of a training program to upskill African healthcare workers to detect RHD using echo.
The project has thus far screened 7100 children. The screening project has changed the lives of 180 children identified with previously undetected RHD (borderline and definite) and instituted secondary prophylaxis and routine follow-up for those respective children as per WHF guidelines. The program has highlighted the scourge of RHD in underserved communities around Cape Town and further emphasizes the importance of an adequate echocardiographic screening initiative in these areas.
The EIA project has had the added benefit of identifying congenital anomalies that require further investigation, follow up and in some cases surgical or percutaneous intervention (all cases treated at TBH). To date, 60 children have been identified with congenital anomalies that require long-term follow-up. These include screened individuals with hypertrophic cardiomyopathy, atrial septal defects, patent ductus arteriosus, mitral valve prolapse, dilated aortic root (marfanoid spectrum), congenital mitral valve clefts, bicuspid aortic valve and children with previously operated congenital heart disease who have been lost to follow up.
Related articles
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Hunter LD, Lombard CJ, Monaghan MJ, Lloyd GW, Franckeiss BM, Pecoraro AJK, Doubell AF, Herbst PG. Screening for rheumatic heart disease: The reliability of anterior mitral valve leaflet thickness measurement. Echocardiography. 2020 Jun;37(6):808-814. doi: 10.1111/echo.14751. Epub 2020 Jun 10. PMID: 32524654.https://doi.org/10.1111/echo.14751
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Hunter LD, Doubell AF, Pecoraro AJK, Monaghan M, Lloyd G, Lombard CJ, Herbst PG. The variable spectrum of anterior mitral valve leaflet restriction in rheumatic heart disease screening. Echocardiography. 2021 May;38(5):729-736. doi: 10.1111/echo.15039. Epub 2021 Apr 13. PMID: 33847025.https://doi.org/10.1111/echo.15039
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Hunter LD, Lloyd GW, Monaghan MJ, Pecoraro AJK, Doubell AF, Herbst PG. Congenital bicuspid aortic valve: Differential prevalence across different South African population groups. S Afr Med J. 2020 Jul 29;110(8):13035. doi: 10.7196/SAMJ.2020.v110i8.14854. PMID: 32880286.
https://doi.org/10.7196/samj.2020.v110i8.14854
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Hunter LD, Monaghan M, Lloyd G, Pecoraro AJK, Doubell AF, Herbst PG. Prominent inter-scallop separations of the posterior leaflet of the mitral valve: an important cause of 'pathological' mitral regurgitation. Echo Res Pract. 2018 Mar 23;5(2):K29–34. doi: 10.1530/ERP-18-0010. Epub ahead of print. PMID: 29572293; PMCID: PMC5900448.
https://doi.org/10.1530/erp-18-0010 -
Hunter LD, Monaghan M, Lloyd G, et alInterscallop separations of the posterior mitral valve leaflet: a solution to the 'borderline RHD' conundrum?Open Heart 2020;7:e001452. doi: 10.1136/openhrt-2020-001452.
https://doi.org/10.1136/openhrt-2020-001452 -
Hunter LD, Pecoraro AJK, Doubell AF, Monaghan MJ, Lloyd GW, Lombard CJ, Herbst PG. Screening for subclinical rheumatic heart disease: addressing borderline disease in a real-world setting. Eur Heart J Open. 2021 Dec 27;1(3):oeab041. doi: 10.1093/ehjopen/oeab041. PMID: 35919886; PMCID: PMC9242066.https://doi.org/10.1093/ehjopen/oeab041
