A Controlled Study of Three Methods of Prophylaxis against Streptococcal Infection in a Population of Rheumatic Children

A Scarlatinal «Nachkrankheit» of Schick: Rheumatic Fever, 50 Years Later

“…In the most extensive controlled study reported on this point, it has been found that 200,000 units of penicillin administered daily as a single dose to a large group of rheumatic subjects did not afford greater protection than a single daily dose of 1.0 gram of sulfa diazine, and indeed may actually have been inferior (53). To im prove upon the results obtained with oral sulfonamides, it may be necessary to employ a tablet of 200,000 units of penicillin twice daily, a regimen which has the important limitation of considerably greater expense.…”

“…Indeed, carefully controlled studies in matched groups of patients have shown this method to be the most effective yet employed for continuous prophylaxis (53). In two recent studies, it was shown that when patients on this regimen were followed for a total of 432 patient years, there was not a single recurrence of rheumatic fever in a school age population who had had rheumatic fever within two years of the onset of the prophylactic regimen and who were exposed to social and economic conditions known to result in the highest incidence of new rheumatic attacks (53,43). Several other studies have confirmed the effectiveness of this regimen (12,20,23).…”

Children’s heart disease in sub-Saharan Africa: Challenging the burden of disease

“…(42) At reinfection, the incidence increases sharply to more than 75% of patients. (43,44,45) During ARF, carditis is present in 40-80% of patients; of those with carditis, 90% will develop chronic progressive RHD. (46,47,48,49) ( Figure 2.…”

Epidemiology of valvular heart diseases in Africa

“…(11,12) About 3% of GABHS pharyngitis cases will develop RF of left untreated, but the risk of RF increases substantially to about 75% with a recurrent episode of GABHS pharyngitis. (13)(14)(15) The precise pathogenic mechanism of RF has not been fully defi ned. …”