Control Of Rheumatic Fever Research Articles

Rheumatic fever control programme in India

Rheumatic fever control programme in India

Cost-effective control of rheumatic fever in the community

Rheumatic fever is declining rapidly in importance in the developed countries, but is still a major public health problem in the developing countries. Primary prevention techniques, consisting of the detection and antibiotic treatment of streptococcal infections of the pharynx, are both feasible and effective, but are also costly, as only 10–20% of all pharyngeal infections are due to the beta-hemolytic Streptococcus, and only a small proportion of those actually develop into rheumatic heart disease. A different concerted approach, which is both effective and economically entirely justifiable, is to use antibiotics as a prophylaxis to prevent secondary infection, i.e. relapses of rheumatic fever. A multi-centre study conducted by the WHO has shown that the cost of antibiotics used for secondary prevention was less than the savings resulting from the lower incidence and shorter hospital stays of recurrencies of rheumatic fever. Given economic restrictions, therefore, priority is given to organized and systematic secondary prevention.

Epidemiological approaches to understanding the pathogenesis of rheumatic fever.

Thus, in 1985, over four decades after discovery of the first important clue towards understanding the pathogenesis of rheumatic fever, medical science still has not defined the mechanism(s). Objective evaluation of available data from around the world indicates that penicillin alone will not lead to effective control. Furthermore, in geographical areas where streptococcal infections, rheumatic fever and rheumatic heart disease are most prevalent, it seems unlikely that standards of living will rise quickly enough to impact on the incidence of this disease during the next several decades. There is renewed worldwide interest in and emphasis on the implementation of rheumatic fever control programmes. The World Health Organization (WHO), in collaboration with the International Society and Federation of Cardiology (ISFC), is promoting a strategy to develop national programmes for the prevention of rheumatic fever and rheumatic heart disease. In 1984-5, designated by the ISFC as the Year of the Rheumatic Child, the WHO Cardiovascular Disease Unit initiated plans to collaborate with 15 developing countries in the development and implementation of rheumatic fever control programmes. Because of the inescapable conclusion that control methods are most efficiently applied when pathogenetic mechanisms are understood, additional epidemiological data should be collected to assist both basic scientists and clinicians in understanding more about this unique disease.

Streptococcal Pharyngitis and Acute Rheumatic Fever in Rhode Island

A comprehensive survey of physicians, laboratories, and hospital records in Rhode Island showed that more than 157,000 throat cultures for a population of 930,000 people were done in 1980. Eighty-seven percent of primary care physicians prescribed antibiotic therapy before culture results were known, and almost 40% continued antibiotic therapy for ten days regardless of culture results. The throat culture positivity rate for beta-hemolytic Streptococcus was 17% statewide in 1980. Only three definite and seven possible cases of acute rheumatic fever were identified by hospital chart reviews and a physician survey covering the five years 1976 through 1980. Current throat culture practices probably have little influence on treatment of streptococcal pharyngitis and control of rheumatic fever in the state.

Strategies for prevention and control of rheumatic fever and rheumatic heart disease.

Strategies for prevention and control of rheumatic fever and rheumatic heart disease.

The Control of Rheumatic Fever

The Control of Rheumatic Fever

Control of rheumatic fever in developing countries.

Steps which need to be taken for control of rheumotic fever keeping in mind the available resources in developing countries are the establishment of a national rheumatic fever control programme, which should be linked with school health care programme. Cases of rheumatic heart disease should be detected and referred to RHD registries for secondary prophylaxis programme. In the high risk age group of 5–15 years the parents and teachers should be vigilant about sore throat, which should be diagnosed and treated vigorously. The establishment of laboratory competence in streptococcal bacteriology and serology all over the country is of prime importance.

Worldwide Control of Rheumatic Fever

Excerpt The World Health Organization convened a meeting of expert staff members and consultants in Geneva during 1977 to consider the prospects for worldwide rheumatic fever control. Their report,...

State registries and the control of rheumatic fever.

State registries and the control of rheumatic fever.

Control of rheumatic fever

Control of rheumatic fever

Control of Rheumatic Fever

To the Editor.— I read with interest the editorial Control of Rheumatic Fever: How Are We Doing? (237:1720, 1977). The following statement was of interest to me: World War II an average of 2.06 cases of acute rheumatic fever occurred per 1,000 activeduty Navy personnel; during the years 1968 through 1970, this rate declined 96% to 0.08 cases per 1,000 annually. During World War II, I was a Naval Medical Officer stationed at the US Navy Training Center, Farragut, Idaho. During that time streptococcal infections were rampant at the training center. I doubt that a day went by that at least one Navy personnel was not sent to the hospital with acute rheumatic fever. The total number of Navy personnel with rheumatic fever at this particular base was really unbelievable. I suggest that Mortimer might wish to reevaluate his statistics after excluding all cases of acute rheumatic fever from

Control of rheumatic fever: how are we doing

Control of rheumatic fever: how are we doing

Control of Rheumatic Fever: How Are We Doing?

The American Heart Association has recently published updated recommendations for the prevention of acute rheumatic fever.¹These recommendations are essentially the same as those first published 24 years ago²; the major differences are a consequence of the development of injectable penicillin G benzathine and of erythromycin, and the demonstration that group A streptococci frequently exhibit resistance to the tetracyclines. The similarities indicate that there have been very few changes in our approach to the control of rheumatic heart disease since it was first shown that acute rheumatic fever can be averted by appropriate treatment of the inciting streptococcal infection and that recurrent rheumatic fever can be prevented by continuous prophylaxis. We still do not know how to predict among those with streptococcal infections who are at risk for rheumatic fever, how to distinguish streptococcal carriers from those with actual infection except in retrospect, or exactly how the<i>Streptococcus</i>

The control of rheumatic fever.

Not only does an attack [ of rheumatic fever] not confer immunity, but predisposes the subject to the disease. — Sir William Osler, The Principles and Practice of Medicine

Rheumatic Fever, ed. 2 (vol. II in the series Major Problems in Clinical Pediatrics), by Milton Markowitz, M.D., and Leon Gordis, M.D., Dr.P.H. Philadelphia/London/Toronto: W. B. Saunders, 1972, 309 pp., $11.50

Although a number of texts devoted to special aspects of rheumatic fever have appeared within the past half century, Milton Markowitz, first in the 1965 edition with Ann Kuttner and now in an updated and amplified edition with Leon Gordis, has provided the first objective and comprehensive monograph on this disease since 1924, when Carey Coombs's Rheumatic Heart Disease was published. In view of the advances in our knowledge of the etiology and control of rheumatic fever that have been made since the days of Carey Coombs, this monograph by Markowitz and Gordis answers a long felt need.

Control of rheumatic fever and rheumatic heart disease in Egypt.

Control of rheumatic fever and rheumatic heart disease in Egypt.

Rheumatic Fever, Throat Cultures, and Penicillin

E. A. Mortimer, Jr., commenting on the "Role of the Pediatrician in Rheumatic Fever Control,"1 deplores the fact that first attacks of rheumatic fever have been reduced only 30% compared with the "prepenicillin" era, whereas prophylaxis has reduced recurrences by 75%. He feels that this is because (A) a significant proportion (from 34% to 56%) of initial attacks occurred in patients whose physicians either did not recognize or treated inadequately the antecedent streptococcal infection, and (B) parents failed to seek medical help for ‘pharyngitis of insufficient severity."

Study on Life Style of the Patients of Rheumatic Fever Attending the National Centre for Control of Rheumatic Fever and Heart Diseases (NCCRF/HD) During the Year 1993 to 1996

A Retrospective study was designed to see the status of housing and living environment of the patients of Rheumatic fever. The study was done from January to June 1997 on 477 (Four hundred seventy seven) patients of Rheumatic fever whose data were collected from the records of National Centre for Control of Rheumatic Fever and Heart Diseases (NCCRF/HD), Sher-E-Bangla Nagar, Dhaka. All of them were diagnosed cases of Rheumatic fever of both sexes attended the hospital from the year 1993 to 1996. The study showed that 257 (54%) patients out of 477 came from a family comprising of 7 members or more, 196 (41%) patients from a family comprising of 4-6 members. 50.1% cases resides in kutcha house, 32.9% and 17% cases resides in Pukka and semi-pukka house, respectively. The study shows that 67% of the patients came from the house consisting of 1-2 living rooms, 27.9% from the house consisting of 3-4 rooms. Family comprising of more members, type of residing house especially kutcha house and house consisting of less living rooms increases the incidence of the Rheumatic fever. Key words: Rheumatic fever; Family members; Type of housing and living rooms. DOI: 10.3329/jdmc.v17i2.6579J Dhaka Med Coll. 2008; 17(2) : 56-58

Rheumatic fever control measures: acceptance of routine pharyngeal cultures.

THE concepts upon which an adequate program for prevention of rheumatic fever can be based were discussed in a previous report. 1 These concepts have been almost universally accepted by workers in the field of rheumatic fever, yet they have not been widely applied in actual practice. In general, the programs for the prevention of primary rheumatic fever can be categorized into: (1) school-oriented programs as described by Phibbs; 2 (2) mass prophylaxis as used by the armed services; 3 (3) mass treatment of streptococcal epidemic areas as described by Zimmerman and Sciple; 4 and finally, (4) adequate detection and treatment of streptococcal disease in private physicians' offices. 1,5-7 For each of these approaches, the indications, practicality, and effectiveness depends on variables such as socioeconomic conditions, availability of medical care, and motivation of the community. In some situations a combination of these approaches may be indicated. However, the scope of

Prevention and Control of Rheumatic Fever and Rheumatic Heart Disease

Prevention and Control of Rheumatic Fever and Rheumatic Heart Disease