Acute rheumatic fever in children in the Ankara area in 1990–1992 and comparison with a previous study in 1980–1989

Abstract

Two hundred and twenty-eight patients with acute rheumatic fever (ARF), who were admitted to Dr Sami Ulus Children's Hospital between January 1990 and November 1992, were evaluated. Compared with the 1980s, an increase in the frequency of the disease was observed. The majority of patients (56.5%) were between 9 and 12 years old and 36.8% were admitted in winter. One hundred patients had arthritis only, 59 carditis and 40 chorea; 5 had carditis and chorea and 24 had arthritis and carditis. Nineteen percent of patients had a history of a previous attack. Seven of 84 patients with carditis had congestive heart failure and 2 had pericarditis. Cardiomegaly was present in 36 patients. The mitral valve was affected in 77 patients, tricuspid valve in 1 patient and both miral and aortic valves in 6 patients. One patient died as a result of severe congestive cardiac failure. Twenty-one patients had a recurrent attack. We observed that ARF is still a significant cause of morbidity in our country. As the disease is preventable by the eradication of streptococcus, we conclude that more effort should be made in the early detection and treatment of streptococcal infections.

Long term follow-up results of 139 Turkish children and adolescents with rheumatic heart disease

“…Income distribution is not fairly balanced in Istanbul, such that 20% of the highest income group uses 64% of the resources based on 1994 statistics. It is documented that the incidence rate of acute rheumatic fever in Turkey seems to be increasing and is as high as 107 per 100,000 among children [8].…”

“…The overall incidence of acute rheumatic fever varies from 20 to 100 cases per 100,000 in different reports from Turkey [8,16]. Additional information about rheumatic heart disease showed that more than 50% of the episodes of acute rheumatic fever cause carditis, which might progress gradually to chronic rheumatic heart disease [9,13].…”

Antibiotic Susceptibility of Streptococcus Pyogenes Strains Isolated From Throat Cultures of Children With Tonsillopharyngitis

“…Because the nonsuppurative sequels of S. pyogenes infections are still an important problem in Turkey and invasive infections due to S. pyogenes have increased recently, the treatment of infections due to S. pyogenes is very important in our country (11). Because of these observations, it is important to determine the current status of antibiotic susceptibility of S. pyogenes strains.…”

Did we overcome rheumatic heart disease or is it still a public disease burden?

“…These findings demonstrate the importance of echocardiographic screening for the early recognition of the disease and the immediate onset of secondary antibiotic prophylaxis [21,22]. Studies on RHD and ARF in our country have reported different results regarding the frequency of these diseases [23][24][25]. This is not surprising considering the heterogeneous nature of our country in terms of socioeconomic level.…”