ABSTRACT
Zika virus infection affects more than 80 countries in the world, mainly those with a tropical climate. Although the most frequent clinical presentation is characterized by rash, conjunctivitis, myalgia, arthralgia and fever, in some cases it is associated with cardiovascular manifestations, such as myocarditis, pericarditis, heart failure and arrhythmias. Furthermore, maternal transmission of the virus generates congenital Zika syndrome, which is associated with cardiac septal defects. Early recognition and treatment of Zika's cardiovascular complications are essential to reduce morbidity and mortality in these patients. There is no specific antiviral treatment or vaccine in humans, so the development of public health strategies to prevent its transmission is of paramount importance. The "Neglected Tropical Diseases and other Infectious Diseases" (NET-Heart project) is an initiative to systematically review all these devastating endemic conditions affecting the heart to spread knowledge and propose algorithms for early diagnosis and treatment.
Subject(s)
Communicable Diseases , Myocarditis , Pericarditis , Zika Virus Infection , Zika Virus , Humans , Myocarditis/diagnosis , Myocarditis/epidemiology , Myocarditis/therapy , Zika Virus Infection/complications , Zika Virus Infection/diagnosis , Zika Virus Infection/epidemiologyABSTRACT
Introduction: Neglected tropical diseases (NTDs) are a group of infections that are prevalent in many of the tropical and sub-tropical developing countries where poverty is rampant. NTDs have remained largely unnoticed in the global health agenda. There is a substantial gap between the burden of disease for NTDs in cardiovascular diseases (CVD) and research devoted to the affected populations. We created a Latin-American initiative with emerging leaders (EL) from the Interamerican Society of Cardiology (IASC) with the objective to perform multiple systematic reviews of NTDs and other infectious diseases affecting the heart: The NET-Heart Project. Objective: To describe the rationale and design considerations of the NET-Heart project. Methods: The NET-Heart Project is a collaborative work of the IASC EL program. The main objective of the NET-Heart project is to systematically evaluate the available evidence of NTDs and other infectious diseases and their cardiovascular involvement. As a secondary objective, this initiative aims to offer recommendations and potential diagnostic and therapeutic algorithms that can aid the management of cardiovascular complications of these infectious diseases. After an expert discussion 17 initial infectious diseases were selected, for each disease we created one working group. The project was structured in different phases: Systematic review, brainstorming workshops, analysis and results, manuscript writing and recommendations and evaluation of clinical implications. Conclusion: The NET-Heart project is an innovative collaborative initiative created to assess burden and impact of NTDs and other infectious diseases in CVD. NTDs can no longer be ignored and must be prioritised on the health and research agenda. This project aims to review in depth the evidence regarding cardiac compromise of these serious conditions and to propose strategies to overcome barriers for efficient diagnosis and treatment of cardiovascular complications.
