December 2025

This is the scientific medical article published in November 2025 with the participation of Etiopia-Witten.

Download the complete article (DOI-10-5830-CVJA-2025-080)

Further information:

Despite the serious financial and personnel shortages that continue to exist in the post-war period at the largest university hospital in Ethiopia's northern province of Tigray, Ayder Hospital in Mekelle, scientific work continues to be performed and reported on there in addition to patient treatment.

Associate Professor and cardiologist Abraha Hailu MD from Ayder Hospital, together with other leading cardiologists in Ethiopia, has published a detailed report on a particularly worrying problem in the treatment of patients who need penicillin to treat their advanced heart disease.

This is rheumatic heart disease, which in young adults can be the result of purulent tonsillitis in childhood under unfavorable circumstances.

Based on their own patient experiences, they describe how, in severely ill patients with additional restrictions in heart function in connection with the underlying disease, the painful injection of benzathine penicillin is provoking rare sudden fatal events, as already observed elsewhere. This is not an allergic reaction or the result of penicillin contamination. It is most likely the result of a so-called vagal reaction, with a drop in blood pressure and a slowing of the heartbeat, which cannot be overcome in the case of severely pathologically reduced cardiovascular function. In healthy individuals, this vagal reaction is observed as a brief, rapidly spontaneous, and inconsequential fainting spell in connection with painful medical procedures.

The two German cardiologists, Gabriele Wehr and Christian Leuner from the Etiopia-Witten Association, have been working together with cardiologists at Ayder Hospital since 2018 in the field of training to prevent rheumatic heart disease in Ethiopia. They also contributed to the article that has now been published. The publication of the article in the internationally recognized Cardiovascular Journal of Africa was made possible by donations from the Etiopia-Witten association.