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Article History

Accepted: 26 January 2026

First Online: 26 February 2026

Competing interests

: L.Z. has research supported by the Division of Research Capacity Development, Foreign Commonwealth and Development Office, UK, National Research Foundation of South Africa, South African Medical Research Council, (grant number Mid-Career Scientist Program, MR/S005242/1), Gates Foundation, British Heart Foundation through the University of Manchester, The Leducq Foundation and Coeffiecient Giving. She is also a member of RHD Vaccine Advisory Committee of the Leducq Foundation. A.B. has research supported by the NIH, Thrasher Research Foundation, The Leducq Foundation, The American Heart Association and Open Philanthropy. She also receives programmatic support from Edwards Lifesciences Foundation, The Philips Foundation and Huron Philanthropies. R.K.K. is a member of RHD Heart Valve Advisory Committee of the LeDucq Foundation. N.J.M. is an inventor on a patent related to streptococcal serology. D.W. reports funding from the NIH (1R01HL164615) for rheumatic heart disease research. C.Y. is partially supported by the NIH under award numbers U01AI151801 and D43TW012246. The funding body, however, had no role in the design of the study and collection, analysis and interpretation of data, and in writing the manuscript. J.C. is supported by an Investigator Grant from the National Health and Medical Research Council of Australia. All other authors declare no competing interests.