The Changing Incidence of Acute Rheumatic Fever in the Province of Manitoba

Abstract

BACKGROUND: The aim of this study was to determine the incidence of Acute Rheumatic Fever (ARF) between the First Nation (FN) and non First Nation (n-FN) children in the Province of Manitoba, Canada. METHODS AND RESULTS: This is a retrospective study conducted at the Children's Hospital of Winnipeg and Variety Heart Centre, Winnipeg, MB, Canada. Children with a discharge diagnosis of ARF over 10-years (2000-2010), were identified through the Children's Hospital of Winnipeg medical records and the Electronic Echocardiography data based at the Variety Heart Centre. The diagnosis of ARF was based on the revised Jones criteria. A total of 61 patientsmeeting the Jones criteria for the diagnosis of ARF are included in this study. The overall annual incidence rate of ARF in the province of Manitoba was 1.613/100,000 with 4.748/100,000 for FN and 0.618/100,000 for the n-FN children (p-value <0.001). CONCLUSION: Comparison of the incidence of ARF in the province of Manitoba from the present study with those previously published, demonstrate a significant decline in the overall incidence as well as in FN and n-FN children (see table 1). Although the incidence ofARFhas dramatically declined; our study suggests that it remains a significant health problem between the First Nation children of Manitoba. Further epidemiological investigation is necessary to determine the nature of this association and a strategy of primary prevention based on health education, improvement of social conditions, access to care, early diagnosis and effective treatment of the disease should be implemented.