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Study protocol for controlled human infection for penicillin G against Streptococcus pyogenes: a double-blinded, placebo-controlled, randomised trial to determine the minimum concentration required to prevent experimental pharyngitis (the CHIPS trial)

Regular intramuscular benzathine penicillin G injections have been the cornerstone of rheumatic heart disease (RHD) secondary prophylaxis since the 1950s. As the pharmacological correlate of protection remains unknown, it is difficult to recommend changes to this established regimen. Determining the minimum effective penicillin exposure required to prevent Streptococcus pyogenes infection will accelerate development of new long-acting penicillins for RHD prevention as well as inform opportunities to improve existing regimens. The CHIPS trial will address this knowledge gap by directly testing protection afforded by different steady state plasma concentrations of penicillin in an established model of experimental human S. pyogenes pharyngitis.

Trends in penicillin dispensing during an acute rheumatic fever prevention programme

Acute rheumatic fever (ARF), a serious inflammatory condition, often leads to rheumatic heart disease. Between 2011 and 2016, Aotearoa New Zealand implemented a rheumatic fever prevention programme to reduce high rates of ARF through improved community access to timely diagnosis and early treatment of group A streptococcal pharyngitis, which has been shown to prevent subsequent ARF.

Rheumatic heart disease: Tools for implementing programmes

This article discusses the World Health Organization program for monitoring & managing rheumatic heart disease.

The 5 × 5 path toward rheumatic heart disease control: Outcomes from the third rheumatic heart disease forum

This editorial viewpoint regarding the outcomes from the third global Rheumatic Heart Disease Forum intends to carry forward dialogue & engage new...

Controlling acute rheumatic fever and rheumatic heart disease in developing countries: Are we getting closer?

Improved opportunities for the primary prevention of ARF now exist, because of point-of-care antigen tests for Streptococcus pyogenes, and clinical decision...

Prevalence of rheumatic heart disease in young adults from New Caledonia

The prevalence of echocardiographically diagnosed RHD in adults in New Caledonia is estimated at 5.9 per 1000

Susceptibility to acute rheumatic fever based on differential expression of genes involved in cytotoxicity, chemotaxis, and apoptosis

Differences in the immune response, detectable by gene expression, between individuals who are susceptible to ARF and those who are not

Echocardiographic screening in a resource poor setting: Borderline rheumatic heart disease could be a normal variant

Cross-sectional observational study across ten primary schools in Fiji in school children aged 5-14 years.

Echocardiographic screening for rheumatic heart disease in high and low risk Australian children

We aimed to establish the prevalence of RHD in high-risk Indigenous Australian children using these criteria and to compare the findings with a group of...

Benzathine penicillin G for the management of RHD: Concerns about quality and access, and opportunities for intervention and improvement

Benzathine penicillin G is an important antibiotic for the treatment and prevention of group A streptococcal infections associated with rheumatic fever and...