Rheumatic Fever: New Ideas in Diagnosis and Management

Rheumatic heart disease remains a major cause of disability and death in developing countries. careful re-analysis of mid- 20th century data as well as the juxtaposition of well-funded research units and populations at risk have generated information that resulted in radical departures from standard approaches to the prevention; clinical recognition and treatment of acute rheumatic fever. As a result; rheumatic heart disease may be eliminated in the future

Epidemiology of Valvular Heart Diseases in Africa

Rheumatic heart disease (RHD) resulting from rheumatic fever (RF) is the main form of valve disease in Africa. Other forms of valve diseases such as myxomatous mitral valve disease; age-related valve disease; -valvular aneurysms or valve disease related to endomyocardial fi brosis are less common than RHD. In developed countries; RF and RHD are rare and no longer pose a public health problem; but the combination of poverty; lack of awareness; lack of infrastructure and resources; and social instability contribute to the persistence of RF and RHD in Africa. The presence of other major infectious diseases also shifts attention away om RF and RHD. Contemporary population-based epidemiologic data utilising echocardiography to detect valve disease suggests the prevalence of valve diseases in Africa is likely much higher than previously thought; meaning the estimated mortality; morbidity and socio-economic burden they cause could also be much higher than currently appreciated. Increased efforts are needed to defi ne the scope of the problem of valve diseases in Africa to draw attention to these illnesses and step up public health efforts to control and eradicate them as has already been achieved in other parts of the world. This article highlights the public health problem of valve diseases in Africa; the efforts underway to combat them and the attendant challenges

Rheumatic Fever and Rheumatic Heart Disease: Where are we now in South Africa?

South Africa continues to face unacceptably high rates of rheumatic fever (RF) and rheumatic heart disease (RHD); despite readily available and inexpensive preventive measures. However; in the past several years; key players in South Africa's healthcare and political realms in addition to key players from many African nations have come together to acknowledge the persistent health burden attributable to RF/RHD and have agreed to a pledge of action to reduce it.The plan of action is a comprehensive RF/RHD prevention and treatment programme known as ASAP. The ASAP programme targets efforts to raise Awareness; establish surveillance systems; Advocate for increased resources for treatment; and to promote Prevention strategies. South Africa currently has a demonstration site where activities in all of these key areas are currently underway. Efforts in the area of surveillance include a RHD prevalence study that aims to screen 4 000 school-aged children through the use of a mobile echo-surveillance unit. In addition to local efforts; South Africa will join an international initiative to create a global RHD registry that will aid in all aspects of prevention and treatment to further reduce the burden of disease attributable to RF/RHD