A Sore Throat Can Hurt Your Child's Heart

With funding from the Edwards Lifesciences “Every Heartbeat Matters” initiative, three Stanford-India Biodesign (SIB) Fellows have created a culturally appropriate and provocative video that depicts early symptoms of rheumatic heart disease (RHD) and the serious consequences that can result if those effected do not seek medical treatment. This public service video, called “A Sore Throat Can Hurt Your Child’s Heart,” will begin screening in parts of India in 2018.

In 2015, SIB fellows Shashi Ranjan, Debayan Saha, and Harsh Sheth did extensive needs finding around RHD in India. After months of on-the-ground research in resource-constrained settings, the team determined that the greatest need in this area was for a way to increase awareness of how RHD affects children in order to improve their early diagnosis and treatment. 

Rheumatic heart disease is the most common heart disease in people under the age 25. The majority of cases are in developing countries. RHD typically presents in childhood as strep throat, which if not medically treated, can progress to rheumatic fever and cause serious heart valve damage.  By young adulthood, the damage to the heart from untreated RHD can result in disability, repeated hospitalization, heart failure, stroke, and death.  ^[i],[ii]

Early medical treatment can prevent the development of rheumatic fever.  However, many families rely on home remedies that do not address the underlying disease. As a result, rheumatic fever is one of the major causes of cardiovascular disease in India, accounting for roughly 25-45 percent of acquired heart disease. [iii] The video, which is just three minutes in length, educates families about the warning signs of RHD and encourages them to see a qualified medical provider as soon as symptoms are detected.

Professor Anurag Mairal of Stanford Biodesign helped facilitate a Memorandum of Understanding between the Government of Chhattisgarh, one of the areas most affected by RHD, and Stanford University to ensure broad access to the video across that state.  It is anticipated that the video will ultimately reach several hundred-thousand people across the country with its life-saving message.

About Stanford-India Biodesign

Stanford-India Biodesign (SIB) was launched in 2007 as a first-of-its-kind collaboration between Stanford University, the All India Institute of Medical Sciences (AIIMS), and the Indian Institute of Technology (IIT) Delhi. The goals of this partnership were to identify and train a first generation of local innovation leaders in medical technology who, in turn, would help stimulate India’s nascent medtech industry.

From the outset, Stanford Biodesign identified a critical success factor for the program: it had to focus on training India-based innovators to develop new technologies specifically for the Indian healthcare environment rather than furthering the country’s reliance on western technologies (according to some estimates, more than 80% of all medical devices are imported into the country).

To accomplish this ambitious objective, the SIB program was designed with two distinct parts. First, each class of four SIB fellows, all Indian nationals, would travel to Stanford for six months of world-class training in the Biodesign innovation process. During those six months, the SIB fellows would work in multidisciplinary teams to learn and apply this process to real-world healthcare projects identified in Stanford’s hospitals and clinics. For the second part of the SIB program, the fellows would then return to Delhi to repeat the process, this time to address the unique unmet healthcare needs of Indian patients, physicians, and healthcare facilities, and to take their innovative solutions forward into patient care.

Over the program’s nine-year duration, Stanford-India Biodesign helped ignite an innovation mindset within the broader Indian medtech ecosystem and coalesce a fragmented group of stakeholders, including the Indian Government, device manufacturers, and funders. The Indian innovation ecosystem is now a vibrant community that includes more than a dozen innovation training programs that are directly or indirectly modeled after SIB in academia and private sector organizations. 

Thanks to SIB’s successful track record, our Indian partners transitioned to independent status. The program is known today as the School of International Biodesign based at AIIMS. Our former SIB fellows are now leading and advising this initiative. 

_{[i] ”HD Affects the World’s Poorest, Most Vulnerable Populations,” World Heart Federation, https://www.world-heart-federation.org/programmes/rheumatic-heart-disease/ (December 6, 2017).
[ii] “Rheumatic Fever and Rheumatic Heart Disease,” National Health Portal, India,  https://www.nhp.gov.in/disease/communicable-disease/rheumatic-fever-and-rheumatic-heart-disease (December 6, 2017).
[iii] Ibid.}