2008 Recipient - Rheumatic Heart Disease Prevention Program, Tonga

The Rheumatic Heart Disease Prevention Program in Tonga received the 2008 Louise Lown Heart Hero Award. The program screens primary school children for rheumatic heart disease and provides early, effective treatment. ProCor's 2008 Heart Hero, Dr. Toakase Fakakovikaetau, initiated the program.

Dr. Toa (as she is known to her patients) was presented with the award on 20 October 2008 at a dinner attended by over 80 health professionals, government officials, and business people in Nuku'alofa, Tonga. The Honourable Mr. Viliami Tau Tangi, Deputy Prime Minister and Minister of Health of Tonga, presented the award plaque.

"Toa is the only pediatrician in Tonga and is the mother of four children," said Samantha Colquhoun, World Heart Federation. "She is, on her own and without external support, achieving what many other regions are unable to achieve with far more resources. Tonga is deserving of additional support to build on the base that Dr. Toa has created and develop an integrated RHD prevention program."

Tonga, a 465-square-mile island nation in the South Pacific Ocean, comprises 169 islands, 36 of them inhabited, with a total population of 102,000.

Dr. Toa pledged the money to establish the Tonga Heart Foundation. Receiving the Heart Hero Award has brought attention to her work in RHD prevention and garnered support from her country, the Pacific region, and the rest of the world. "Several businesses are already keen to support the foundation's work," she said.

Dr. Toa felt that the award will further provide the help needed. "This is one way to assess the screening program and the secondary prophylaxis to see the trend on the need for valve surgery among children and young adults in the next five to 20 years," she said.

Dr. Siale Akau'ola, Medical Superintendent at Vaiola Hospital in Nuku'alofa, said that he was proud that Tonga was the second country to receive the Heart Hero Award.

According to Dr. Toa, the Ministry of Health plans to allocate a budget to further help with RHD screening. The Ministry of Education are also very supportive and "they have given us their blessing," she said. Parent-teacher associations at the schools are very appreciative of the program, as well.

Rheumatic heart disease deaths occur almost exclusively in developing countries, primarily affecting children, adolescents, and young adults. Many cases are detected too late, when the disease has progressed to cardiac failure. A study published in Nature Clinical Practice reported that Tonga has the highest prevalence (confirmed by echocardiogram) of rheumatic heart disease in the world (1).

ProCor's award review committee chose the 2008 winner from applications from 14 countries, including Rwanda, Indonesia, Israel, Eritrea, Mauritius, Nigeria, the Philippines, Iran, South Africa, India, Nepal, Kenya, and the US.

[Read more about the program in the August/September 2008 issue of Heart Beat, the World Heart Federation's e-newsletter.]

Citations:
1. Carapetis JR, Hardy M, Fakakovikaetau T, et al. Evaluation of a screening protocol using auscultation and portable echocardiography to detect asymptomatic rheumatic heart disease in Tongan schoolchildren. Nature Clinical Practice Cardiovascular Medicine 2008; 5: 411-417. www.nature.com/ncpcardio/journal/v5/n7/full/ncpcardio1185.html.

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Project update: Dr. Toa was profiled in the 20 June 2009 issue of the Lancet (Lancet 2009; 373: 2013). "Toakase Fakakovikaetau: pioneering paediatrician in Tonga" describes her dedicated efforts to screen Tongan schoolchildren for rheumatic heart disease and provide early treatment so they can grow up healthy. Read more.

Date Posted: 25 October 2008