Acute rheumatic fever and the evolution of rheumatic heart disease: A prospective 12 year follow-up report

Majeed, H. A.; Batnager, Sudhair; Yousof, A. M.; Khuffash, Faisal A.; Yusuf, Abdul Razak

doi:10.1016/0895-4356(92)90070-4

Cited by 62 publications

(31 citation statements)

References 18 publications

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“…2,3 There are very few published studies4,5 regarding valvular dysfunction in children with RHD in the Sub-Saharan region of Africa which has the world's highest prevalence of RHD (15-20 per 1000 people). 6 Most of the publications 7-12 so far have been from adults studies that also included a small proportion of children.…”

mentioning

confidence: 99%

Echocardiographic pattern and severity of valve dysfunction in children with rheumatic heart disease seen at Uganda Heart Institute, Mulago hospital.

Lubega¹,

Aliku²,

Lwabi³

2014

Afr H. Sci.

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Abstract:Background: Rheumatic heart disease (RHD) is the commonest acquired heart disease in children worldwide but in Uganda, data is scarce regarding its morbidity and mortality. The disease has a progressive course and patients usually require valve repair/replacement in the future. Objectives:To describe the frequency of echocardiographic valvular dysfunction in children with RHD To explore the relationship between the severity of valvular dysfunction by the age and sex of the children with RHD Methods: Echocardiographic findings of children ≤15 years with RHD seen at Uganda Heart Institute from January 2007 to December 2011 were retrospectively analyzed. Results: 376 children had a diagnosis of RHD. The mean age of the children was 11.0±2.7 years and 216 (57.4%) were females. Mitral regurgitation was the commonest lesion seen in 98.9% (severe in 73.1%) of the children. Aortic regurgitation (AR) was found in 51.3% (severe in 7.2%), mitral stenosis (MS) was found in 10.6% (severe in 5.9%), tricuspid regurgitation was found in 86.7% (severe in 8.2%) while aortic stenosis was seen in 1.3% (severe in 0.3%). Severe AR was less common in females (OR=0.32, 95%CI 0.13-0.78) and children with MS were older than those without MS (12.7±2.0 Vs. 10.7±2.7 years, p<0.00). Conclusions: Mitral valve dysfunction was found in almost all the cases of RHD and majority of the children had severe valve disease at the time of their first presentations. Children with MS were predominantly above 10 years and severe AR was more common in males.

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confidence: 99%

Echocardiographic pattern and severity of valve dysfunction in children with rheumatic heart disease seen at Uganda Heart Institute, Mulago hospital.

Lubega¹,

Aliku²,

Lwabi³

2014

Afr H. Sci.

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“…5 Besides, many cases of ARF do not follow clinically identified pharyngitis. 6 Register-based secondary prevention programs can be effective at limiting recurrent ARF and progression to RHD, 7,8 but require early and correct diagnosis of ARF/RHD, followed by long-term administration of an antibiotic (usually benzathine penicillin) on a regular basis. The establishment of a register of patients with known past ARF and/or RHD is the central requirement of a secondary prevention program.…”

mentioning

confidence: 99%

Assessment of a register‐based rheumatic heart disease secondary prevention program in an Australian Aboriginal community

Eissa

Lee

et al. 2005

Australian and New Zealand Journal of Public Health

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A cute rheumatic fever (ARF) and its sequelae are now rare in wealthy industrialised nations.1 Yet, ARF and rheumatic heart disease (RHD) remain important causes of mortality and chronic ill health in poor countries and minority Indigenous populations, such as Aboriginal Australians. 2,3 In the Top End of the Northern Territory, 2.7% of Aboriginal people have an episode of ARF in their lifetime, compared with 0.014% of the non-Aboriginal population. 4 Primary prophylaxis of ARF, the provision of antibiotics to treat streptococcal pharyngitis, is largely unworkable and unsustainable in high-incidence populations, especially where health services are underresourced. 5 Besides, many cases of ARF do not follow clinically identified pharyngitis. Register-based secondary prevention programs can be effective at limiting recurrent ARF and progression to RHD, 7,8 but require early and correct diagnosis of ARF/RHD, followed by long-term administration of an antibiotic (usually benzathine penicillin) on a regular basis. The establishment of a register of patients with known past ARF and/or RHD is the central requirement of a secondary prevention program.9,10 Evaluation of service delivery is regarded as an important part of program design. 11,12A register-based RHD secondary prevention program was established in the Top End of the Northern Territory (NT) in 1997.13 New and recurrent cases of ARF are notif iable in the NT. Clinicians are encouraged to inform the register of all new cases of ARF and newly diagnosed RHD, including 'probable' cases where the diagnosis has not been proven but there is a high index of suspicion. Sources of data for the register include notifications, hospital discharge records, community clinic records, echocardiogram reports and professional correspondence. The register keeps details

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“…(8,24,33,106) Many notable successes have been reported through prevention programmes with decreased prevalence, hospital morbidity and mortality; for example in Cuba, Costa Rica, Egypt, Martinique and Guadeloupe, (12,16,60,61,107,108,109,110,111,112,113) and the development of the A.S.A.P. proposal holds similar promise in this regard for Africa.…”

Section: Preventionmentioning

confidence: 90%

“…A single attack of ARF may progress to RHD, but most RHD results from the cumulative damage of repeated attacks. (11,12,13,14) Over the past century the incidence of ARF and RHD has declined steeply in developed countries; the initial and most rapid decline was before the antibiotic era, due mainly to improving socioeconomic conditions. (15,16,17) RHD is today rarely seen in developed nations; (18,19,20) already by the 1980s it was thought to be virtually eradicated.…”

Section: Acquired Heart Diseasementioning

confidence: 99%

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

Hewitson

Zilla

2017

SAHJ

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Acute rheumatic fever and the evolution of rheumatic heart disease: A prospective 12 year follow-up report

Cited by 62 publications

References 18 publications

Echocardiographic pattern and severity of valve dysfunction in children with rheumatic heart disease seen at Uganda Heart Institute, Mulago hospital.

Echocardiographic pattern and severity of valve dysfunction in children with rheumatic heart disease seen at Uganda Heart Institute, Mulago hospital.

Assessment of a register‐based rheumatic heart disease secondary prevention program in an Australian Aboriginal community

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

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