Implementation of a National Rheumatic Fever and Rheumatic Heart Disease prevention and control Program in Egypt: Rationale and Objectives

Abstract

Background: Rheumatic heart disease (RHD) remains a major public health challenge in Egypt, with a school-age prevalence of 0.9%–2.5%. Despite national initiatives since 2006, control has been constrained by low public and provider awareness, suboptimal secondary prophylaxis, misdiagnosis, and fragmented surveillance. This report outlines the rationale and structure of Egypt's national RF/RHD prevention and control program, which integrates screening, digital surveillance, capacity building, and research to support scalable RHD control in endemic settings. Methods: The program comprises (1) mandatory RF notification and a national electronic registry for public-sector cases and screening positives; (2) nationwide school-based echocardiographic screening of >10,000 children across 27 governorates using standardized clinical examination and World Heart Federation criteria; (3) Characterization of regional patterns and determinants of RHD; (4) Development of region-specific risk stratification tools, guidelines, diagnostic criteria and prevention strategies; (5) nationwide multimedia awareness campaigns; (6) Capacity building through continuous medical education and training at all care levels; and (7) and embedded high-impact research and clinical trials. Conclusions: Egypt's national RF/RHD prevention and control program provides a comprehensive and scalable framework that combines school-based screening, mandatory notification, a national registry, workforce training, public awareness, and embedded research to improve case detection, support timely prophylaxis, and generate local evidence for risk stratification and policy, modelling an approach suitable for other endemic settings.