The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study

Nan Phyu Sin Toe Myint, Ne Myo Aung, Myint Soe Win, Thu Ya Htut, Anna P. Ralph, David A. Cooper, Myo Lwin Nyein, Mar Mar Kyi, Josh Hanson

Research output: Contribution to journalArticlepeer-review

39 Downloads (Pure)


Background: Rheumatic heart disease (RHD) is a major cause of premature death in low and middle-income countries. The greatest barrier to RHD control is neglect of the disease in national health policies and a lack of prevalence data that might inform control efforts. Myanmar is making remarkable progress against many infectious diseases, but there are almost no data to define the clinical burden of RHD in the country. This prospective audit was performed in an adult medical ward of a tertiary-referral hospital in Yangon, to gain an insight into the prevalence of RHD in Myanmar. 

Principal findings: All patients admitted to the ward between May 1, 2016 and April 30, 2017 were eligible for enrolment. RHD was confirmed in 96 patients who were admitted on 134 occasions, representing 1.1% of the 12,172 adult medical admissions during the study period. This compared with 410 (3.4%) admissions with HIV and 14 (0.1%) with malaria. Patients with RHD had a median age of 44 years (interquartile range: 35–59); 70 (73%) were female. Only one patient had ever had surgery despite 79 (82%) meeting criteria for intervention; 54 (56%) patients were not receiving any regular clinician review. Prior to hospitalisation only 18 (19%) patients were receiving regular penicillin. Only 8 (19%) of the 42 women <50 years were using contraception. Of 49 patients who had been hospitalised previously, 22 (45%) were receiving no regular therapy. During the study three (3.1%) patients died, and 28 (29%) were lost to follow-up. Of the 65 (68%) alive and retained in care, 21 (32%) were still experiencing moderate-severe RHD-related symptoms at the study’s end. 

Conclusions: There is a significant and unmet clinical burden of RHD in Myanmar. A national RHD programme would improve patient care, reducing morbidity and mortality from this preventable disease.

Original languageEnglish
Article numbere0192880
Pages (from-to)1-14
Number of pages14
JournalPLoS One
Issue number2
Publication statusPublished - 21 Feb 2018


Dive into the research topics of 'The clinical characteristics of adults with rheumatic heart disease in Yangon, Myanmar: An observational study'. Together they form a unique fingerprint.

Cite this